Exercising immune cells: The immunomodulatory role of exercise on atrial fibrillation

Prog Cardiovasc Dis. 2021 Sep-Oct:68:52-59. doi: 10.1016/j.pcad.2021.07.008. Epub 2021 Jul 16.

Abstract

Exercise training is generally beneficial for cardiovascular health, improving stroke volume, cardiac output, and aerobic capacity. Despite these benefits, some evidence indicates that endurance training may increase the risk of atrial fibrillation (AF), particularly in highly trained individuals. Among multiple mechanisms, autonomic tone changes and atrial remodeling have been proposed as main contributors for exercise-induced AF. However, the contribution of local and systemic immunity is poorly understood in the development of atrial arrhythmogenic substrates. Here we aim to update the field of immunomodulation in the context of exercise and AF by compiling and reconciling the most recent evidence from preclinical and human studies and rationalize the applicability of "lone" AF terminology in athletes.

Keywords: Atrial fibrillation; Atrial remodeling; Exercise training; Fibrosis; Inflammation; Innate immune system.

Publication types

  • Review

MeSH terms

  • Animals
  • Athletes*
  • Atrial Fibrillation / etiology*
  • Atrial Fibrillation / immunology
  • Atrial Fibrillation / metabolism
  • Atrial Fibrillation / physiopathology
  • Cardiomegaly, Exercise-Induced
  • Cytokines / metabolism
  • Heart Atria / immunology*
  • Heart Atria / metabolism
  • Heart Atria / physiopathology
  • Heart Rate*
  • Humans
  • Immune System / immunology*
  • Immune System / metabolism
  • Immune System / physiopathology
  • Immunity, Innate*
  • Inflammation Mediators / metabolism
  • Physical Exertion / immunology*
  • Risk Assessment
  • Risk Factors
  • Signal Transduction

Substances

  • Cytokines
  • Inflammation Mediators