title: Combined endurance/resistance training reduces plasma TNF-alpha receptor levels in patients with chronic heart failure and coronary artery disease.
abstract: OBJECTIVE
  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.
  
  
  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).
  
  
  CONCLUSIONS
  Besides an overall beneficial effect on exercise capacity, combined endurance/resistance exercise training has an anti-inflammatory effect in patients with CHD and CAD.
authors.affiliation: Department of Cardiology, University Hospital Antwerp (UIA), Wilrijkstraat 10, 2650 Edegem, Belgium.
authors.forename: V M
authors.initials: VM
authors.lastname: Conraads
authors.forename: P
authors.initials: P
authors.lastname: Beckers
authors.forename: J
authors.initials: J
authors.lastname: Bosmans
authors.forename: L S
authors.initials: LS
authors.lastname: De Clerck
authors.forename: W J
authors.initials: WJ
authors.lastname: Stevens
authors.forename: C J
authors.initials: CJ
authors.lastname: Vrints
authors.forename: D L
authors.initials: DL
authors.lastname: Brutsaert
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003327:Coronary Disease / Q000097:blood / Q000534:rehabilitation*; D016207:Cytokines / Q000097:blood; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000534:rehabilitation*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D010807:Physical Endurance; D018124:Receptors, Tumor Necrosis Factor / Q000097:blood*
chemical_list: D016207:Cytokines; D015850:Interleukin-6; D018124:Receptors, Tumor Necrosis Factor