Article

In patients with heart failure, inflammation has been associated with
worse functional capacity, but it is uncertain whether it could affect their
response to exercise training. We evaluated whether inflammatory biomarkers are
related to differential effect of exercise on the peak oxygen uptake (V O2) among
patients with heart failure. Design Open, parallel group, randomized controlled
trial. Methods Patients with heart failure and ejection fraction </=0.4 were
randomized into exercise training or control for 12 weeks.
Patients were
classified according to: 1) inflammatory biomarkers blood levels, defined as
'low' if both interleukin-6 and tumor necrosis factor-alpha blood levels were
below median, and 'high' otherwise; and 2) galectin-3 blood levels, which also
reflect pro-fibrotic processes. Results Forty-four participants (50 +/- 7 years
old, 55% men, 25% ischemic) were allocated to exercise training ( n = 28) or
control ( n = 16). Exercise significantly improved peak V O2 among participants
with 'low' inflammatory biomarkers (3.5 +/- 0.9 vs. -0.7 +/- 1.1 ml/kg per min, p
= 0.006), as compared with control, but not among those with 'high' inflammatory
biomarkers (0.4 +/- 0.6 vs. -0.2 +/- 0.7 ml/kg per min, p = 0.54, p for
interaction = 0.009). Similarly, exercise improved peak V O2 among participants
with below median (2.4 +/- 0.8 vs. -0.3 +/- 0.9 ml/kg per min, p = 0.032), but
not among those with above median galectin-3 blood levels (0.3 +/- 0.7 vs. -0.7
+/- 1.0 ml/kg per min, p = 0.41, p for interaction = 0.053). Conclusion In
patients with heart failure, levels of biomarkers that reflect pro-inflammatory
and pro-fibrotic processes were associated with differential effect of exercise
on functional capacity. Further studies should evaluate whether exercise training
can improve clinical outcomes in patients with heart failure and low levels of these biomarkers.

Langue : ANGLAIS