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Exercise training in chronic heart failure: effects on pro-inflammatory markers.
Josef Niebauer1, Andrew L Clark, Katherine M Webb-Peploe
1Cardiac Medicine, Royal Brompton Hospital and NHLI, London, UK. j.niebauer@medizin.uni-leipzig.de
European Journal of Heart Failure
|February 11, 2005
Summary
Chronic heart failure (CHF) patients show elevated inflammatory markers. Chronic exercise training improved fitness but did not activate these inflammatory markers, unlike acute exercise bouts.
Area of Science:
- Cardiovascular Physiology
- Exercise Immunology
Background:
- Patients with chronic heart failure (CHF) exhibit heightened inflammatory cytokine activation and peripheral hypoxia following acute exercise.
- Elevated levels of tumor necrosis factor alpha (TNFalpha) and markers of endothelial damage are characteristic of CHF.
Purpose of the Study:
- To investigate the long-term effects of chronic exercise training on pro-inflammatory cytokines and endothelial damage markers in CHF patients.
- To compare the impact of chronic exercise versus rest on these markers.
Main Methods:
- A randomized cross-over study involving 18 CHF patients and 9 controls over 8 weeks.
- Interventions included 8 weeks of daily submaximal bicycle ergometer and calisthenics training versus 8 weeks of rest.
- Measurements included TNFalpha, soluble TNF-receptors (1 and 2), IL-6, soluble e-selectin, sICAM, and sCD14.
Main Results:
- Baseline CHF patients had lower peak Vo(2) and elevated sICAM, TNFalpha, and TNF-R2 compared to controls.
- Exercise training significantly increased peak Vo(2) in CHF patients (p<0.003).
- Neither chronic exercise training nor rest led to the activation of measured inflammatory or endothelial damage markers in either group.
Conclusions:
- Chronic heart failure is linked to increased TNFalpha and endothelial damage markers.
- Unlike acute exercise, chronic exercise training does not appear to activate pro-inflammatory cytokines or markers of endothelial damage in CHF patients.