Review Article
Aerobic Versus Resistance Exercise Training and Coronary Angiogenesis in Elite Football (Soccer) Players: A Systematic Review
Mohsen Davoodi*
Issue:
Volume 11, Issue 5, October 2025
Pages:
74-79
Received:
8 September 2025
Accepted:
22 September 2025
Published:
10 October 2025
Abstract: Coronary angiogenesis, the formation of new micro vessels from pre-existing vasculature, is a crucial adaptive response enhancing myocardial perfusion and potentially reducing cardiovascular risk in athletes. Elite football (soccer) players experience unique hemodynamic loads combining aerobic endurance and anaerobic bursts. This systematic review critically evaluates current evidence comparing the distinct and synergistic effects of aerobic endurance training (AET) and resistance exercise training (RET) on molecular pathways and potential for stimulating coronary angiogenesis in this specific athletic cohort. Analysis of recent literature (primarily 2019-2024) reveals that AET predominantly enhances coronary angiogenesis through chronic elevation of laminar shear stress, significantly up regulating endothelial nitric oxide syntheses (eNOS), vascular endothelial growth factor (VEGF), and hypoxia-inducible factor-1α (HIF-1α) expression. RET, characterized by intermittent high-pressure pulsatile flow, robustly activates mechanosensitive pathways (e.g., PI3K/Akt/mTOR) and increases circulating VEGF and angiopoietin-2, though its direct coronary effects are less documented. Football-specific training inherently blends both modalities, suggesting potential synergy. However, human in vivo evidence for direct coronary angiogenesis remains challenging to obtain; current conclusions rely heavily on peripheral vascular surrogates, animal models, molecular biomarkers, and advanced imaging (CMR perfusion). Future research utilizing novel molecular imaging and sport-specific exercise interventions is paramount to elucidate optimal training prescriptions for maximizing coronary vascular health in elite footballers.
Abstract: Coronary angiogenesis, the formation of new micro vessels from pre-existing vasculature, is a crucial adaptive response enhancing myocardial perfusion and potentially reducing cardiovascular risk in athletes. Elite football (soccer) players experience unique hemodynamic loads combining aerobic endurance and anaerobic bursts. This systematic review ...
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