Article

Cardiac rehabilitation (CR) improves the symptoms, exercise capacity
and quality of life of chronic heart failure (CHF) patients. Its effects on new
plasma biomarkers of prognostic importance are unknown.
The present study aimed
at analysing the effects of a structured CR programme on plasma cardiac
biomarkers in a large population of patients with CHF and reduced left
ventricular ejection fraction (LVEF). Methods We enrolled 107 consecutive CHF
patients with LVEF </= 45% in an ambulatory CR programme. Peak VO2 and plasma
levels of Galectin-3, mid-regional proANP (MR-proADM), soluble suppressor of
tumorigenicity 2 (sST2) and mid-regional pro-adrenomedullin
(MR-proANP) were
assessed at inclusion and at the end of CR. Twenty-four unenrolled patients were
managed with standard medical care and evaluated over the same period (no-CR
group). Results Galectin-3, sST2, MR-proADM and MR-proANP plasma levels decreased
after CR, with respective median reductions of 6.3% for Galectin 3 ( p < 0.001),
7.4% for sST2 ( p = 0.036), 6.4% for MR-proADM ( p = 0.001) and 16% for MR-proANP
( p < 0.001). MR-proADM was negatively correlated with peak VO2 (rho = -0.529,
95% confidence interval [CI] -0.654 to -0.375, p < 0.001),
and so were their
relative variations along the course of CR (rho = -0.357,
95% CI -0.518 to
-0.172, p < 0.001). No change occurred in terms of biomarkers in the no-CR group.
Conclusions Plasma cardiac biomarkers such as Galectin-3, MR-proADM, sST2 and
MR-proANP all decreased after CR in CHF patients, suggesting an overall
improvement in the neuro-hormonal profile.

Langue : ANGLAIS