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Riveland E, Valborgland T, Ushakova A, Skadberg Ø, Karlsen T, Hole T, Støylen A, Dalen H, Videm V, Koppen E, Linke A, Delagardelle C, Van Craenenbroeck EM, Beckers P, Prescott E, Halle M, Omland T, Ellingsen Ø, Larsen AI. Exercise training and high-sensitivity cardiac troponin-I in patients with heart failure with reduced ejection fraction. ESC Heart Fail 2024; 11:1121-1132. [PMID: 38268237 DOI: 10.1002/ehf2.14674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/01/2023] [Accepted: 12/27/2023] [Indexed: 01/26/2024] Open
Abstract
AIMS The aims of this sub-study of the SMARTEX trial were (1) to evaluate the effects of a 12-week exercise training programme on serum levels of high sensitivity cardiac troponin I (hs-cTnI) in patients with moderate chronic heart failure (CHF), in New York Heart Association class II-III with reduced ejection fraction (HFrEF) and (2) to explore the associations with left ventricular remodelling, functional capacity and filling pressures measured with N-terminal pro brain natriuretic peptide (NT-proBNP). METHODS AND RESULTS In this sub-study, 196 patients were randomly assigned to high intensity interval training (HIIT, n = 70), moderate continuous training (MCT, n = 59) or recommendation of regular exercise (RRE), (n = 67) for 12 weeks. To reveal potential difference between structured intervention and control, HIIT and MCT groups were merged and named supervised exercise training (SET) group. The RRE group constituted the control group (CG). To avoid contributing factors to myocardial injury, we also evaluated changes in patients without additional co-morbidities (atrial fibrillation, hypertension, diabetes mellitus, and chronic obstructive pulmonary disease). The relationship between hs-cTnI and left ventricular end-diastolic diameter (LVEDD), VO2peak, and NT-proBNP was analysed by linear mixed models. At 12 weeks, Hs-cTnI levels were modestly but significantly reduced in the SET group from median 11.9 ng/L (interquartile ratio, IQR 7.1-21.8) to 11.5 ng/L (IQR 7.0-20.7), P = 0.030. There was no between-group difference (SET vs. CG, P = 0.116). There was a numerical but not significant reduction in hs-cTnI for the whole population (P = 0.067) after 12 weeks. For the sub-group of patients without additional co-morbidities, there was a significant between-group difference: SET group (delta -1.2 ng/L, IQR -2.7 to 0.1) versus CG (delta -0.1 ng/L, IQR -0.4 to 0.7), P = 0.007. In the SET group, hs-cTnI changed from 10.9 ng/L (IQR 6.0-22.7) to 9.2 ng/L (IQR 5.2-20.5) (P = 0.002), whereas there was no change in the CG (6.4 to 5.8 ng/L, P = 0.64). Changes in hs-cTnI (all patients) were significantly associated with changes in; LVEDD, VO2peak, and NT-proBNP, respectively. CONCLUSIONS In patients with stable HFrEF, 12 weeks of structured exercise intervention was associated with a modest, but significant reduction of hs-cTnI. There was no significant difference between intervention group and control group. In the sub-group of patients without additional co-morbidities, this difference was highly significant. The alterations in hs-cTnI were associated with reduction of LVEDD and natriuretic peptide concentrations as well as improved functional capacity.
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Affiliation(s)
- Egil Riveland
- Department of Cardiology, Stavanger University Hospital, Stavanger, Norway
- Institute of Clinical Science, University of Bergen, Stavanger, Norway
| | | | - Anastasia Ushakova
- Department of Research, Section of Biostatistics, Stavanger University Hospital, Stavanger, Norway
| | - Øyvind Skadberg
- Department of Biochemistry, Stavanger University Hospital, Stavanger, Norway
| | - Trine Karlsen
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
- Department of Circulation and Medical Imaging, Cardiac Exercise Research Group, Norwegian University of Science and Technology, Trondheim, Norway
| | - Torstein Hole
- Department of Circulation and Medical Imaging, Cardiac Exercise Research Group, Norwegian University of Science and Technology, Trondheim, Norway
- Møre og Romsdal Health Trust, Ålesund Hospital, Ålesund, Norway
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Asbjørn Støylen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Håvard Dalen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
- Clinict of Cardiology, St. Olavs University Hospital, Trondheim, Norway
| | - Vibeke Videm
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Immunology and Transfusion Medicine, St. Olavs University Hospital, Trondheim, Norway
| | - Elias Koppen
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Axel Linke
- Technische Universität Dresden, Herzzentrum, Dresden, Germany
| | | | - Emeline M Van Craenenbroeck
- Department of Cardiology, Antwerp University Hospital, Edegem, Belgium
- Research Group Cardiovascular Diseases, Translational Pathophysiological Research, University of Antwerp, Antwerp, Belgium
| | - Paul Beckers
- Department of Cardiology, Antwerp University Hospital, Edegem, Belgium
- Research Group Cardiovascular Diseases, Translational Pathophysiological Research, University of Antwerp, Antwerp, Belgium
| | - Eva Prescott
- Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Martin Halle
- Department of Prevention and Sports Medicine, Faculty of Medicine, University Hospital 'Klinikum rechts der Isar', Technical University Munich, Munich, Germany
- Munich Heart Alliance, DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung), partner site Munich, Munich, Germany
| | - Torbjørn Omland
- Department of Cardiology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Øyvind Ellingsen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Clinict of Cardiology, St. Olavs University Hospital, Trondheim, Norway
| | - Alf Inge Larsen
- Department of Cardiology, Stavanger University Hospital, Stavanger, Norway
- Institute of Clinical Science, University of Bergen, Stavanger, Norway
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Abdeen HA, Helmy ZM, Elnaggar MI, Aldhahi MI, Taha MM, Marques-Sule E, Amin DI, Ibrahim BS, Abdel Aziz A, Castiglione V, Atef H. Different Continuous Training Intensities Improve Echocardiographic Parameters, Quality of Life, and Functional Capacity in Heart Failure Patients with Reduced Ejection Fraction. Int J Gen Med 2023; 16:3933-3945. [PMID: 37670928 PMCID: PMC10475351 DOI: 10.2147/ijgm.s420933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/10/2023] [Indexed: 09/07/2023] Open
Abstract
Background Multiple comorbidities and physiological changes play a role in a range of heart failure conditions and influence the most effective approach to exercise-based rehabilitation. This research aimed to examine and compare the outcomes of continuous training at three different intensities, focusing on left ventricular (LV) remodeling, functional capacity, and quality of life among patients with heart failure with reduced ejection fraction (HFrEF). Methods In this randomized control trial, a total of 60 male patients (average age: 54.33 ±2.35 years) with HFrEF were randomly allocated into three groups: 1) High-intensity continuous training group (HICT), 2) Moderate-intensity continuous training group (MICT), and 3) Low-intensity continuous training group (LICT). All the training was performed on a bicycle ergometer 3 times/week for 12 weeks. Echocardiographic parameters (left ventricular ejection fraction, left ventricular end-diastolic dimension, left ventricular end-systolic dimension, N-terminal pro-B-type natriuretic peptide (NT-proBNP), quality of life (Minnesota Living with Heart Failure Questionnaire), and functional capacity (6-minute walking test) were assessed before and the end of the study. Results The HICT group demonstrated the greatest improvements in all measured variables when compared to the other two groups (P < 0.05). These findings were consistent across all measured outcomes. Conclusion It was determined that HICT appears to yield the most favorable outcomes in enhancing echocardiographic measures, NT-proBNP levels, quality of life, and functional capacity among HFrEF patients.
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Affiliation(s)
- Heba A Abdeen
- Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, 11432, Egypt
| | - Zeinab M Helmy
- Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, 11432, Egypt
| | - Moustafa I Elnaggar
- Faculty of Physical Therapy, Heliopolis University for Sustainable Development, Giza, Egypt
| | - Monira I Aldhahi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Mona Mohamed Taha
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Elena Marques-Sule
- Physiotherapy in Motion, Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Doaa I Amin
- Basic Science Department, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | | | | | - Vincenzo Castiglione
- Fondazione Toscana Gabriele Monasterio; “Health Science” Interdisciplinary Research Center, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Hady Atef
- Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, 11432, Egypt
- School of Allied Health Professions (SAHP), Keele University, Staffordshire, UK
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Malandish A, Gulati M. The impacts of exercise interventions on inflammaging markers in overweight/obesity patients with heart failure: A systematic review and meta-analysis of randomized controlled trials. Int J Cardiol Heart Vasc 2023; 47:101234. [PMID: 37416483 PMCID: PMC10320319 DOI: 10.1016/j.ijcha.2023.101234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/22/2023] [Accepted: 06/18/2023] [Indexed: 07/08/2023]
Abstract
Objectives The purpose of this meta-analysis was to investigate the association of aerobic, resistance and concurrent exercises vs. control group on inflammaging markers [tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), IL-1-beta, IL-8, and high sensitivity C-reactive protein (hs-CRP)] in overweight or obesity patients with heart failure (HF). Methods The databases of Scopus, PubMed, Web of Science and Google Scholar were searched until August 31, 2022 for exercise interventions vs. control group on circulating inflammaging markers in patients with HF. Only randomized controlled trial (RCT) articles were included. Standardized mean difference (SMD) and 95% confidence intervals (95%CIs) were calculated (registration code = CRD42022347164). Results Forty-six full-text articles (57 intervention arms and 3693 participants) were included. A significant reduction was occurred in inflammaging markers of IL-6 [SMD-0.205(95% CI:-0.332 to -0.078),p = 0.002] and hs-CRP [SMD -0.379 (95% CI:-0.556 to -0.202), p = 0.001] with exercise training in patients with HF. Analysis of subgroup by age, body mass index (BMI), type, intensity, duration of exercise and mean left ventricular ejection fraction (LVEF) revealed that there was a significant reduction in TNF-α for middle-aged (p = 0.031), concurrent training (p = 0.033), high intensity (p = 0.005), and heart failure with reduced ejection fraction (HFrEF) (p = 0.007) compared to the control group. There was a significant reduction in IL-6 for middle-aged (p = 0.006), overweight (p = 0.001), aerobic exercise (p = 0.001), both high and moderate intensities (p = 0.037 and p = 0.034), short-term follow-up (p = 0.001), and heart failure with preserved ejection fraction (HFpEF) (p = 0.001) compared to the control group. There was a significant reduction in hs-CRP for middle-aged (p = 0.004), elderly-aged (p = 0.001), overweight (p = 0.001), aerobic exercise (p = 0.001), concurrent training (p = 0.031), both high and moderate intensities (p = 0.017 and p = 0.001), short-term (p = 0.011), long-term (p = 0.049), and very long-term (p = 0.016) follow-ups, HFrEF (p = 0.003) and heart failure with mildly reduced ejection fraction (HFmrEF) (p = 0.048) compared to the control group. Conclusions The results confirmed that aerobic exercise and concurrent training interventions were effective to improve inflammaging markers of TNF-α, IL-6, and hs-CRP. These exercise-related anti-inflammaging responses were observed across ages (middle-aged and elderly-aged), exercise intensities, duration of follow-ups, and mean LVEFs (HFrEF, HFmrEF and HFpEF) in overweight patients with HF.
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Affiliation(s)
- Abbas Malandish
- Department of Exercise Physiology, Faculty of Sport Sciences, Urmia University, No. 19, Shams Tabrizi St., Velayat Ave., Keikhali Zone, Yamchi, East Azerbaijan, Urmia, Iran
| | - Martha Gulati
- Barbra Streisand Women’s Heart Center, Smidt Heart Institute, Cedars Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3600, Los Angeles, CA 90048, USA
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Malandish A, Karimi A, Naderi M, Ghadamyari N, Gulati M. The impacts of exercise interventions on inflammatory markers and vascular adhesion molecules in patients with heart failure: A meta-analysis of RCTs. CJC Open 2023. [DOI: 10.1016/j.cjco.2023.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
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Zare Karizak S, Kashef M, Gaeini AA, Nejatian M. Impact of high intensity interval and moderate continuous training on plasma ratios of ProBNP 1-108/BNP 1-32 and NT-pro-BNP 1-76/BNP 1-32 after coronary artery bypass grafting surgery. Front Physiol 2023; 14:1114813. [PMID: 36960152 PMCID: PMC10030057 DOI: 10.3389/fphys.2023.1114813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 02/22/2023] [Indexed: 03/09/2023] Open
Abstract
Background: ProBNP1-108/BNP1-32, and NT-pro-BNP1-76/BNP1-32 ratios are significant indices for predicting complications after coronary artery bypass grafting (CABG) surgery. However, the effect of aerobic training types on these biomarkers has not been fully understood. So, the current study aimed to determine the impact of aerobic interval and continuous training programs on plasma ratios of ProBNP1-108/BNP1-32 and NT-pro-BNP1-76/BNP1-32 after coronary artery bypass grafting surgery. Method: 36 patients were selected purposive (27 men and 9 women with mean of age 60.32 ± 5.81 years, height 164.64 ± 9.25 cm, weight 73.86 ± 14.23 kg, fat 32.30 ± 4.28, SBP 142.67 ± 6.49, DBP 84.5 ± 5.16 mmHg in seated position at rest situation and functional capacity of 7.08 ± 2.49 METs) and then divided randomly into three groups: control (C) group (without training program) moderate continuous training (MCT) and high intensity interval training (HIIT) (exercise training program was performed 3 days/week for 8 weeks) with intensities 65%-80% and 80%-95% of reserve heart rate in order. Blood samples were taken 48 h before the first session and 48 h after the last training session to measure the plasma levels of ProBNP1-108, corin enzyme, BNP1-32, and NT-pro-BNP1-76 using the enzyme-linked immunosorbent assay (ELISA) technique. Wilcoxin and kruskal wallis tests were used for analyzing data. Results: The plasma corin enzyme was increased, and the ratios of proBNP1-108/BNP1-32 and NT-pro-BNP1-76/BNP1-32 were reduced in both training groups in compared with control group (p = 0.004, p = 0000, p = 0.016, p = 0.003, p = 0.009, and p = 0.016) when there was no significant difference was found between training groups (p = 0.074, p = 450, and p = 0.295). Conclusion: Both high intensity interval training and moderate continuous training in compared with inactivity have positive effects on ratios of ProBNP1-108/BNP1-32, NT-pro-BNP1-76/BNP1-32 and could be effective to promote the health of coronary arteries and prevention of HF in post-CABG patients.
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Affiliation(s)
- Sara Zare Karizak
- Sport Science Department, Faculty of Literature and Humanities, Persian Gulf University, Boushehr, Iran
- *Correspondence: Sara Zare Karizak,
| | - Majid Kashef
- Exercise Physiology Department, Sport Science Faculty, Shahid Rajaee Teacher Training University, Tehran, Iran
| | - Abbas Ali Gaeini
- Exercise Physiology Department, Sport Science Faculty, Tehran University, Tehran, Iran
| | - Mostafa Nejatian
- Cardiac Rehabilitation Specialist and Head of Rehabilitation Clinic of Tehran Heart Center Hospital, Tehran, Iran
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do Nascimento DM, Bock PM, Nemetz B, Goldraich LA, Schaan BD. Meta-Analysis of Physical Training on Natriuretic Peptides and Inflammation in Heart Failure. Am J Cardiol 2022:S0002-9149(22)00584-7. [PMID: 35817596 DOI: 10.1016/j.amjcard.2022.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/18/2022] [Accepted: 05/20/2022] [Indexed: 11/24/2022]
Abstract
Physical training has been reported to attenuate myocardial stress and inflammation in heart failure (HF). We aimed to assess the impact of physical training on B-type natriuretic peptide and N-terminal pro-B-type natriuretic peptide (NT-proBNP), as well as biomarkers of inflammation-C-reactive protein, tumor necrosis factor α (TNF-α), and interleukins (ILs). A systematic electronic literature search was conducted up to May 2021 in PubMed, Cochrane Library, CINAHL, Embase, and SPORTDiscus to identify randomized clinical trials reporting associations between any formal physical training intervention and biomarker levels in patients with HF. Random-effects meta-analyses was used to calculate pooled correlations between physical training and blood biomarkers. Biomarker outcomes were expressed as mean difference or ratio of means and 95% confidence interval between the intervention and control groups, according to the normality of the data. A total of 38 trials were included in the final meta-analysis (2,652 randomized patients). Physical training was associated with decreased B-type natriuretic peptide (p = 0.02), NT-proBNP (p <0.01), C-reactive protein (p <0.00001), TNF-α (p = 0.03), IL-6 (p = 0.04), and IL-1β (p = 0.001). Aerobic continuous training was associated with a 35% reduction in NT-proBNP (p = 0.01); ≥150 min/week of exercise was associated with a greater reduction in TNF-α levels (p = 0.0004), and aerobic interval training was associated with lower IL-6 levels (p = 0.01). In conclusion, physical training in patients with HF is associated with beneficial effects on natriuretic peptides and biomarkers of inflammation because they were all reduced by the intervention.
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Zhao Q, Mao F. Effects of Aerobic Training on Cardiopulmonary Function Based on Multiple Linear Regression Analysis. Journal of Healthcare Engineering 2022; 2022:1-6. [PMID: 35360483 PMCID: PMC8964173 DOI: 10.1155/2022/7399119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/21/2022] [Accepted: 01/28/2022] [Indexed: 11/23/2022]
Abstract
In order to study the effect of aerobic training exercise on cardiopulmonary function of the human body, in this study, multiple linear regression based on the particle swarm optimization cardiopulmonary function test method of constructing the sports cardiopulmonary function test model is used. The traditional multiple linear regression after 41 iteration achieves convergence, and after the particle swarm optimization, about 25 times, convergence is achieved. Moreover, the convergence error of pSO is less than that of traditional multiple linear regression algorithm, which verifies the effectiveness of PSO. This method can effectively detect cardiopulmonary function of athletes before and after aerobic training, and the modeling accuracy is high, and the detection performance of cardiopulmonary function of aerobic training is better than the traditional relational model algorithm, which provides a new way for cardiopulmonary model detection of the human body.
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Yingtong M, Wei Z, Hanjun H, Tingting Z, Xiaohua G. The effects of early exercise on cardiac rehabilitation-related outcome in acute heart failure patients: a systematic review and meta-analysis. Int J Nurs Stud 2022; 130:104237. [DOI: 10.1016/j.ijnurstu.2022.104237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 03/17/2022] [Accepted: 03/19/2022] [Indexed: 10/18/2022]
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Bai Y, Hua B, Zhang F, Zhou W, Deng B. Effect of different intensity exercises intervention on cardiovascular functions and quality of life on patients with chronic heart failure: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e28554. [PMID: 35029219 PMCID: PMC8757934 DOI: 10.1097/md.0000000000028554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Exercise training can improve exercise capacity, quality of life, and reduce hospitalization time in chronic heart failure (CHF) patients. Various training protocols have been studied in CHF, but there is no consensus on the optimal exercise intensity for the rehabilitation of cardiac patients. Therefore, systematic evaluation of the effects of different exercise intensities on the efficacy of cardiac function and quality of life in patients with CHF was done. METHODS Computer searches of PubMed, Web of Science, The Cochrane Library, Embase, SinoMed, the China National Knowledge Infrastructure, Wanfang, and VIP databases were conducted to collect randomized controlled trials of different exercise intensities applied to patients with CHF. Study selection and data extraction will be performed simultaneously by two independent reviewers, using the PEDro scale for quality assessment of the included literature. Publication bias will be assessed by funnel plot, and Begg and Egger tests. The I2 statistic and the chi-square (χ2) test will be used to assess heterogeneity. In addition, subgroup analyses will be performed for different left ventricular ejection fraction populations and different intervention cycles. All meta-analyses will be performed using Revman5.3 software. RESULTS The present study is a systematic review and meta-analysis program with no results. Data analysis will be completed after the program has been completed. CONCLUSION This meta-analysis may provide more reliable, evidence-based evidence for the choice of exercise intensity in patients with CHF. REGISTRATION NUMBER CRD42021276529.
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Affiliation(s)
- Yan Bai
- Department of Nursing, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Bin Hua
- Department of Cardiology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Fan Zhang
- Department of Nephrology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wenqin Zhou
- Nursing Teaching and Research Department, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Malandish A, Ghadamyari N, Karimi A, Naderi M. The role of exercise training on cardiovascular peptides in patients with heart failure: A systematic review and meta-analysis. Curr Res Physiol 2022; 5:270-286. [PMID: 35800138 PMCID: PMC9253836 DOI: 10.1016/j.crphys.2022.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/25/2022] [Accepted: 06/20/2022] [Indexed: 12/19/2022] Open
Abstract
Background The purpose of this systematic review & meta-analysis was to determine the roles of aerobic, resistance or concurrent exercises vs. control (CON) group on B-type natriuretic peptide (BNP) and N-terminal-pro hormone BNP (NT-proBNP) in patients with heart failure. Methods The electronic databases of PubMed, Scopus, Web of Science, and Google Scholar were searched up to May 2022 for aerobic vs. CON, resistance vs. CON, and concurrent vs. CON studies on circulating (serum or plasma) levels of BNP and NT-proBNP in patients with heart failure. Non-randomized or randomized controlled trial studies were included. Standardized mean difference (SMD) and 95% confidence intervals (95% CIs) were calculated. This systematic review & meta-analysis was registered in PROSPERO at the University of York with the registration number [CRD42021271632]. Results A total of 28 articles (37 intervention arms), 26 aerobic intervention arms, 3 resistance intervention arms, and 8 concurrent intervention arms were included. A total of 2563 participants (exercise groups = 1350 and CON groups = 1213) were included. Exercise training significantly decreased NT-proBNP marker [-0.229 (SMD and 95% CI: 0.386 to −0.071), p = 0.005], irrespective of overweight/obesity status. Analysis of subgroup by type of exercise training revealed that there was a significant reduction in the NT-proBNP marker for aerobic exercise group compared to the CON group [-0.336 (SMD and 95% CI: 0.555 to −0.105), p = 0.004], whereas concurrent exercise did not show significant changes in the NT-proBNP marker [-0.134 (SMD and 95% CI: 0.350 to 0.083), p = 0.227]. In addition, exercise training did not significantly change the BNP marker [-0.122 (SMD and 95% CI: 0.322 to 0.079), p = 0.235]. Conclusions The results suggested that exercise training, especially aerobic exercise can be improved the NT-proBNP concentrations in patients with HF (irrespective of overweight/obesity status), which may be a sign of positive physiological adaptations to aerobic exercise. Exercise intervention, especially aerobic training can be improved (decreased) NT-proBNP marker in patients with HF. Exercise intervention cannot improve BNP marker in patients with HF. Decreased NT-proBNP marker by aerobic exercise can be considered as a cardiac rehabilitation programme in patients with HF.
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Affiliation(s)
- Abbas Malandish
- Ph.D of Exercise Physiology, Department of Exercise Physiology, Faculty of Sport Sciences, Urmia University, Urmia, Iran
- Corresponding author. No. 19, Shams Tabrizi St., Velayat Ave., Keikhali Zone, Yamchi, East Azerbaijan, Iran. Tel.: (+98) 9143922878
| | - Niloufar Ghadamyari
- Ph.D Stu. of Exercise Physiology, Department of Exercise Physiology, Faculty of Sport Health Sciences, Ankara University, Ankara, Turkey
| | - Asma Karimi
- M.Sc of Applied Exercise Physiology, Department of Exercise Physiology, Faculty of Sport Sciences, Hakim Sabzevari University, Sabzevar, Iran
| | - Mahdi Naderi
- M.Sc of Exercise Physiology, Department of Exercise Physiology, Faculty of Sport Sciences, Kharazmi University, Tehran, Iran
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Tedjasukmana D, Triangto K, Radi B. Aerobic exercise prescription in heart failure patients with cardiac resynchronization therapy. J Arrhythm 2021; 37:165-172. [PMID: 33664899 PMCID: PMC7896451 DOI: 10.1002/joa3.12475] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 11/09/2020] [Accepted: 11/18/2020] [Indexed: 01/09/2023] Open
Abstract
Exercise for heart failure patients had been shown to be beneficial in improving functional status, and was reviewed to be safe. In cases of advanced heart failure, Cardiac Resynchronization Therapy (CRT) is a promising medical option before being a heart transplant candidate. CRT itself is a biventricular pacing device, which could detect electrical aberrance in the failing heart and provide a suitable response. Studies have shown that exercise has clear benefits toward improving an overall exercise capacity of the patients. Despite its impacts, these randomized clinical trials have varying exercise regime, and until now there has not been a standardized exercise prescription for this group of patients. The nature of CRT as a pacemaker, sometimes with defibrillator, being attached to a heart failure patient, each has its own potential exercise hazards. Therefore, providing detailed exercise prescription in adjusting to the medical condition is very essential in the field of physical medicine and rehabilitation. Being classified as a high-risk patient group, exercise challenges for the complex heart failure with CRT patients will then be discussed in this literature review, with a general aim to provide a safe, effective, and targeted exercise regime.
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Affiliation(s)
- Deddy Tedjasukmana
- Department of Physical Medicine and RehabilitationFaculty of MedicineUniversitas IndonesiaJakartaIndonesia
| | - Kevin Triangto
- Department of Physical Medicine and RehabilitationFaculty of MedicineUniversitas IndonesiaJakartaIndonesia
| | - Basuni Radi
- Department of Cardiology and Vascular MedicineFaculty of MedicineUniversitas IndonesiaJakartaIndonesia
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