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Clinical Summary

Does exercise improve levels of inflammatory markers in heart failure patients?

Takeaway

  • This meta-analysis does not provide evidence for a positive effect of exercise training on inflammatory markers (TNF-α, IL-6, C-reactive protein [CRP], fibrinogen, soluble intercellular adhesion molecule [sICAM] and soluble vascular adhesion molecule [sVCAM]) in patients with heart failure.

Why this matters

  • Previous studies evaluating the effect of aerobic and resistance training on inflammatory markers in patients with heart failure have shown inconsistent results.

Study design

  • 20 studies, representing 18 independent trials, met eligibility criteria after a search on PubMed, EMBASE and the Cochrane Library of Controlled Trials up until 30 June 2017.
  • Funding: None disclosed.

Key results

  • Pooled data from 6 studies with 244 participants (145 exercising; 99 control participants) showed a small but statistically significant improvement in TNF-α (standardised mean difference [SMD], 0.42; P=.002).
  • A borderline statistically significant improvement in CRP with exercise was demonstrated by pooled data (3 studies, n=97; SMD, 1.61; P=.05).
  • Pooled data failed to show any significant improvement in fibrinogen (SMD, 0.40; P=.39), sICAM (SMD, 0.33; P=.16) and sVCAM (SMD, 0.33; P=.10).
  • Four studies with 175 participants (110 exercising, 65 controls) demonstrated a small and statistically significant improvement in IL-6 concentrations with exercise (SMD 0.41; P=.01)

Limitations

  • The number of studies was small.
  • Medication usage considered to have an anti-inflammatory effect may have contributed to differing results and heterogeneity between studies.

References


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