Exercise Combined with Rhodiola sacra Supplementation Improves Exercise Capacity and Ameliorates Exhaustive Exercise-Induced Muscle Damage through Enhancement of Mitochondrial Quality Control

Received Jun 22, 2017; Accepted Oct 1, 2017

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1. Introduction

Cardiovascular disease (CVD) is the leading cause of disease death worldwide [1]. It has been firmly established that low level of exercise capacity (EC) is associated with cardiovascular disease mortality and all-cause mortality in patients with CVD [2]. A growing body of epidemiological and clinical evidence demonstrates that EC is a potentially stronger predictor of mortality than established risk factors such as smoking, hypertension, high cholesterol, and type 2 diabetes mellitus [3, 4]. Moreover, numerous recent studies have shown that each 1 MET increment (MET, a multiple of the resting metabolic rate approximating 3.5 ml·kg⁻¹·min⁻¹) in EC is associated with considerable (10%–25%) improvement in survival [5]. A recent scientific statement from the American Heart Association recommended the use of EC as a clinical vital sign [5]. In addition, antistress capacity is currently used as prognostic predictors of major adverse cardiovascular events, including cardiac and all-cause death, nonfatal myocardial infarction, and coronary revascularization, PTCA/CABG, in patients with CVD [6–8]. Kaplan-Meier survival estimates showed a significantly worse outcome in patients presenting with elevated oxidative stress levels [8]. Improved antistress capacity was found to reduce the area of skeletal muscle damage after ischemia or hypoxia [9] as well as the incidence of malignant ventricular arrhythmia after a previous myocardial infarction [10]. Therefore, the development of strategies to improve EC and the capacity to resist acute stress-induced damage are of great clinical significance. This study examined the ability of both nondrug intervention-based and pharmaceutical supplementation to enhance EC and the capacity to resist acute stress-induced damage, with a focus on aerobic exercise (AE) and supplementation with Rhodiola sacra (RS), a traditional natural plant pharmaceutical.

EC reflects the integrated ability to transport oxygen from the atmosphere to the mitochondria to perform physical work. It therefore quantifies...