Clinical InvestigationHeart FailureThe effects of exercise on cardiovascular biomarkers in patients with chronic heart failure
Section snippets
Study population
Details of the design, rationale, and primary results of the HF-ACTION study have been published elsewhere.6., 7. Briefly, HF-ACTION (clinicaltrials.gov: NCT00047437) was a randomized clinical trial evaluating the effect of exercise training versus usual care on long-term morbidity and mortality in 2,331 patients with chronic HF due to left ventricular systolic dysfunction (New York Heart Association [NYHA] classes II-IV, left ventricular ejection fraction [LVEF] <35%).
Exercise testing
Patients were randomized
Baseline characteristics
Baseline and 3-month plasma levels of NT-proBNP, hs-CRP, and cTnT were available for 928 patients, who were broadly similar to the HF-ACTION cohort as a whole (n = 2,331, online Appendix Supplementary Table I). Patient characteristics of this cohort, as a whole and according to randomization group, are shown in Table I. Median age of the study cohort was 59 years; of these, 63% were white, and 71% were male. Most patients were NYHA class II (67%) or NYHA class III (32%) at study onset, and
Discussion
Findings from this study challenge the hypothesis that exercise training improves commonly evaluated cardiovascular biomarkers in patients with chronic HF. We found that plasma levels of NT-proBNP, hs-CRP, or cTnT did not significantly improve at 3 months despite a structured exercise training program, even after accounting for baseline biomarker levels. Although patients who tended to exercise more had lower levels of NT-proBNP and hs-CRP and decreased risk of adverse clinic outcomes, volume
Disclosures
Drs Felker, Fiuzat, and O'Connor have received research funding from BG Medicine, Critical Diagnostics, and Roche Diagnostics. Drs Felker and O'Connor have served as consultants for Roche Diagnostics. Dr Zannad has received research funding from BG Medicine and Roche Diagnostics and served as a consultant for BG Medicine. Dr Kitzman serves as a consultant for Relypsa, Inc. None of the other authors report any conflicts.
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Meta-Analysis of Physical Training on Natriuretic Peptides and Inflammation in Heart Failure
2022, American Journal of CardiologyCitation Excerpt :The most prevalent co-morbidities were hypertension and diabetes mellitus. A total of 8 trials11,15,18,21,30,32,41,43 included patients receiving cardiac resynchronization therapy. Most studies reported data on clinical stability or optimal pharmacological therapy before enrollment in the protocols, which ranged from 4 weeks to more than 12 months.
The role of exercise training on cardiovascular peptides in patients with heart failure: A systematic review and meta-analysis
2022, Current Research in PhysiologyCitation Excerpt :The characteristics of exercise training interventions and control group-related interventions are illustrated in Table 3. Types of exercise interventions including aerobic (Abolahrari-Shirazi et al., 2018; Ahmad et al., 2014; Aksoy et al., 2015; Conraads et al., 2007; Eleuteri et al., 2013; Fu et al., 2013; Giallauria et al., 2006-a; Giallauria et al., 2006-b; Giallauria et al., 2008; Kobayashi et al., 2003; Maria-Sarullo et al., 2006; Masterson-Creber et al., 2015; Melo et al., 2019; Nilsson et al., 2010; Passino et al., 2006; Radi et al., 2017; Sandri et al., 2012; Wisløff et al., 2007; Yeh et al., 2004; Yeh et al., 2011), resistance (Karavidas et al., 2008; Kawauchi et al., 2017), and concurrent (Abolahrari-Shirazi et al., 2018; Adamopoulos et al., 2014; Conraads et al., 2004; Delagardelle et al., 2008; Marco et al., 2013; Prescott et al., 2009; Van Berendoncks et al., 2010) were studies included in our meta-analysis. The intensity ranges for the aerobic exercise interventions were performed from 40% VO2peak (Abolahrari-Shirazi et al., 2018), 60% HRmax reserve (Ahmad et al., 2014; Masterson-Creber et al., 2015), increased heart rate up to 20 bpm above resting (Radi et al., 2017) and 15–18 on the Borg scale (Nilsson et al., 2010) to 70% HRmax reserve (Masterson-Creber et al., 2015), 80% VO2peak (Fu et al., 2013; Prescott et al., 2009), 90% of the ventilator threshold level (Conraads et al., 2004; Conraads et al., 2007; Eleuteri et al., 2013; Kobayashi et al., 2003; van Berendoncks et al., 2010) and as well as 90–95% HRmax (Melo et al., 2019; Wisløff et al., 2007), with the most common exercise intensity 60–75% VO2peak (Delagardelle et al., 2008; Fu et al., 2013; Giallauria et al., 2006a,b; Giallauria et al., 2008; Maria-Sarullo et al., 2006; Passino et al., 2006; Sandri et al., 2012) or 60–70% HRmax reserve (Ahmad et al., 2014; Masterson-Creber et al., 2015).
Clinical trial registration: ClinicalTrials.gov no. NCT00047437.