Aerobic Exercise and S-Klotho Effects on Cardiovascular Disease Patients: A Review

Coronary artery disease (CAD) is the most common type of heart disease progression once major coronary arteries are injured or diseased. When the primary blood arteries which supply the myocardium with blood, oxygen and nutrients is narrowed arterial disease progresses. Plaque buildup in the walls of the arteries from hypercholesterolemia (high blood cholesterol), dyslipidemia, and vascular inflammation contribute to atherosclerosis formation, a primary agent for CAD. Arterial stiffens occurs as a result of the biological aging process and arteriosclerosis. Endothelial dysfunction is characterized by reduced vascular nitric oxide levels. Nitric oxide vascular reductions leads to irregularities in blood artery function. These functional irregularities result from atherosclerosis, causing vasoconstriction of small arteries. Vasoconstriction of smaller arteries is related to hypertension and could possibly influence, left ventricle diastolic dysfunction. There are two forms of klotho; membrane and secreted, membrane klotho acts as co-receptor for fibroblast growth factor (FGF)-23, while secreted klotho (s-klotho) regulates nitric oxide production in the endothelium minimizing endothelial dysfunction. Studies examining the effect of aerobic exercise on blood circulating s-Klotho have demonstrated a fitness dependent response. S-Klotho values have been shown to be significantly higher in trained vs untrained individuals. Aerobic training is an appropriate model for mechanistically probing the role of physical activity on s-Klotho expression. Factors associated with endothelial function improvement; aerobic fitness levels and aerobic training increased s-klotho levels alleviate and attenuate endothelial dysfunction. Aerobic exercise and klotho gene expression is shown to reduce cardiovascular events in patients with prior CAD thereby decreasing mortality risk.

Keywords:Atherosclerosis; Nitric oxide; Reactive oxygen species (ROS); Endothelial dysfunction; Klotho; Coronary artery disease; Oxidative stress