Increased expression of VEGF following exercise training in patients with heart failure

Background and aims During the last decades several angiogenic factors have , been characterized-but so far it is unknown whether local muscle exercise training increases the expression of these factors in patients with modera te heart failure. Expression of the major putative angiogenic factor vascul ar endothelial growth factor (VEGF) at the level of messneger RNA (mRNA) an d/or protein was therefore studied before and after 8 weeks of training in patient with chronic heart failure. Methods VEGF mRNA and protein concentrations were determined in skeletal mu scle biopsies before and after 8 weeks of one-legged knee extension trainin g in patients with chronic heart failure (New York Heart Association II-III ). Results Exercise training increased the citrate synthase activity and perip heral exercise capacity by 46% and 36%, respectively, in parallel with a tw o-fold increase in VEGF at both the mRNA (P = 0.03) and protein (P = 0.02) levels Conclusion The increase in VEGF gene expression in response to exercise tra ining indicates VEGF to be one possible mediator in exercise-induced angiog enesis and may therefore regulate an important and early step in adaptation to increased muscle activity in patient with chronic heart failure.