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Low-intensity aerobic training along with limbs blood flow restriction can improve mass and strength of skeletal muscle, but its effects on aging heart structure and performance is unidentified. We investigated the effects of this model of training on myocardial function, histology and angiogenesis in old male rats.Animals randomly were divided into control (Ctl), sham-operated (Sh), limbs blood flow restriction (BFR), sham-operated plus 10 weeks low intensity treadmill exercise (Sh + Ex), and BFR plus exercise (BFR + Ex) groups. Finally, blood pressure, heart physiological and stereological parameters, myocardial oxygen consumption index and expression of vascular endothelial growth factor (VEGF) and its receptors (Flt-1 and kdr) were assessed.BFR + Ex group had significantly lower heart rate (P < 0.05 vs. Ctl and Sh groups), rate-pressure product (RPP) and left ventricular end diastolic pressure (P < 0.05 and P < 0.01 vs. untrained groups, respectively). BFR + Ex group also had greater +dp/dt max (P < 0.01) and −dp/dt max (P < 0.05) than untrained groups. A significant increase in volumes of left ventricle and myocytes (P < 0.05, vs. Ctl and Sham), ventricular hypertrophy index and capillaries length density (P < 0.05 vs. untrained groups) were observed in BFR + Ex group.The level of VEGF and Flt-1 proteins and their mRNAs increased in the BFR + Ex group compared to Ctl, Sh and BFR (P < 0.01) and Sh + Ex (P < 0.05) groups. The kdr mRNA and its protein level were significantly higher in the BFR + Ex group.Findings suggest that BFR plus exercise through improving the angiogenesis, physiological cardiac remodeling and oxygen demand/supply matching can promote cardiac performance in the elderly rats.Aging is associated with unwanted heart remodeling that leads to cardiac dysfunction.Old rats were subjected to mild training and BFR for ten weeks.Then, cardiac structure and function of aged rats were investigated.BFR plus mild exercise improved the indices of cardiac function and O2 consumption.This effect may mediate via improvement of angiogenesis and physiological hypertrophy.