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European Heart Journal 2002 23(23):1854-1860; doi:10.1053/euhj.2002.3239
Copyright © 2002 by the European Society of Cardiology.
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Combined endurance/resistance training reduces plasma TNF-{alpha} receptor levels in patients with chronic heart failure and coronary artery disease

V.M. Conraadsa,f1, P. Beckersa, J. Bosmansa, L.S. De Clerckb, W.J. Stevensb, C.J. Vrintsa and D.L. Brutsaerta

a Department of Cardiology, University Hospital Antwerp (UIA), Belgium
b Department of Immunology, University Hospital Antwerp (UIA), Belgium

revised March 4, 2002; accepted March 6, 2002

Abstract

Aims Physical reconditioning of patients with chronic heart failure (CHF) improves exercise capacity and restores endothelial function and skeletal muscle changes. The effects of 4 months combined endurance/resistance exercise training on cytokines and cytokine receptors in patients with CHF were studied. In addition, changes in submaximal and maximal exercise performance were addressed.

Methods and Results Twenty-three patients with stable CHF due to coronary artery disease (CAD, n=12) or idiopathic dilated cardiomyopathy (IDCM, n=11) were trained for 4 months. Blood sampling for measurement of plasma concentrations (ELISA) of interleukin (IL)-6, tumour necrosis factor (TNF)-{alpha}, soluble TNF receptor 1 (sTNFR1) and 2 (sTNFR2), as well as cardiopulmonary exercise testing were performed at baseline and after 4 months. Training induced a significant decrease in sTNFR1 (P=0·02) for the total population, and in both sTNFR1 (P=0·01) and sTNFR2 (P=0·02) concentrations for the CAD group only. IL-6 and TNF-{alpha} levels were not altered. Cytokine concentrations remained unchanged in an untrained age- and sex-matched control group. NYHA functional class, submaximal and maximal workrate were significantly improved in both patient groups. Oxygen uptake at the anaerobic threshold (P=0·002) and at peak exercise increased in the CAD patients only (P=0·008).

Conclusion Besides an overall beneficial effect on exercise capacity, combined endurance/resistance exercise training has an anti-inflammatory effect in patients with CHD and CAD.Copyright 2002 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved.

Key Words: Chronic heart failure, inflammation, cytokines, exercise training

f1 Correspondence: Viviane Conraads, MD, Department of Cardiology, University Hospital Antwerp, Wilrijkstraat 10, 2650 Edegem, Belgium.

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