Objective: Although it is generally accepted that endurance training improves cardiac function after myocardial infarction the sub-cellular mechanisms are uncertain. The present study reports the effects of aerobic endurance training on myocardial mass, myocyte dimensions, contractile function, Ca(2+) handling, and myofilament responsiveness to Ca(2+) in cardiomyocytes from healthy and failing rat hearts. Methods: Adult female Sprague-Dawley rats ran on a treadmill 1.5 h/day, 5 days a week for 8 weeks, Exercise intervals alternated between 8 min at 85-90% of V(O2max) and 2 min at 50-60%. Training started 4 weeks after ligation of the left coronary artery (TR-INF, n = 11) or sham operation (TR-SHAM, n = 6). Sedentary animals (SED-SHAM, n = 6; SED-INF, n = 13) were controls. Results: After 6 weeks V(O2max) in TR-INF and TR-SHAM leveled off 65% above sedentary controls. In TR-SHAM, left and right ventricle weights were similar to25% higher an in SED-SHAM, myocytes were similar to13% longer; width remained unchanged. At physiological stimulation frequencies, relative myocyte shortening was markedly higher whereas peak systolic [Ca(2+)] and t(1/2) of Ca(2+) transient decay were 10-20% lower, indicating higher Ca(2+) sensitivity in cardiomyocytes from trained rats. compared to respective controls, In TR-INF the left and right ventricular weights, and myocyte length and width were 15, 23, 12, and 20% less than in SED-INF. Endurance training significantly increased the myocardial SR Ca(2+) pump (SERCA-2) and sarcolemmal Na(+)-Ca(2+)-exchanger (NCX) protein levels to the extent that TR-INF did not differ from SED-SHAM. Conclusion: This is the first study to show that aerobic endurance training attenuates the ventricular and cellular hypertrophy in failing hearts. Furthermore, training consistently restores contractile function, intracellular Ca(2+) handling, and Ca(2+)-sensitivity in cardiomyocytes from rats with myocardial infarction. (C) 2002 Elsevier Science B.V. All rights reserved.