Anemia, heart failure and exercise training

Abstract

We read with interest the recent article by Wang et al. in which theauthors evaluated in anemic patients with heart failure whether exer-tionalperiodicbreathing influences rheological/hemodynamicfunctions[1]. For this purpose, the authors performed an incremental exercisetestusing a bicycle ergometer. In this regard, it has been generally assumedby some researchers, exercise physiologists and scientists that the incre-ment in blood hemoglobin (Hb) content is among the main hematolog-ical adaptations to endurance exercise training. This misconception isbased in the data published in diffe rent studies carried out severalyearsago [2].Inarecentmanuscript byBakeretal. [3],theauthorsdem-onstrated that endurance exercise training increases hematopoiesis,enhancing skeletal muscle hematopoietic cytokine expression, and mo-bilizing medullary hematopoietic stem and progenitor cell content. Themainconclusionofthisstudywasthatendurancetrainingshouldbecon-sidered as a strategy for blood donor preconditioning. The authors alsosuggestthatitwouldbeusefulasaphysiologicaladjuvantforautologousbonemarrowtransplantationorasa first-steptherapyforsomeformsofanemia. In our opinion, and in accordance with the results showed byWangandcollaborators,theseassumptionsarequestionableandagainstthe vast majority of experimental evidence.For instance, in 2000, Bojadjiev and Taralov found that continuous(formorethanoneyear)high-intensitysportstrainingcausedadecreasein blood Hb concentration in pubescent boys and girls [4].Twoyears