title: Change in circulating cytokines after 2 forms of exercise training in chronic stable heart failure.
abstract: BACKGROUND
  A proinflammatory state is recognized in chronic heart failure and the degree of immune activation corresponds to disease severity and prognosis. Training is known to improve symptoms in heart failure but less is known about the effects of specific forms of training on the proinflammatory state.
  
  
  METHODS
  Forty-six patients with stable chronic heart failure underwent a home-based program of exercise training for 30 minutes a day, 5 days per week over a 6-week period. Twenty-four used a bicycle ergometer and 22 used an electrical muscle stimulator applied to quadriceps and gastrocnemius muscles. Tumour necrosis factor-alpha (TNF-alpha), TNF-alpha soluble receptors 1 and 2, interleukin 6, and C-reactive protein were measured before and after the training period.
  
  
  RESULTS
  Significant improvements in markers of exercise performance were seen in both training groups. Soluble TNF-alpha receptor 2 levels decreased after training in the bike group only (2900 +/- 1069 pg/mL to 2625 +/- 821 pg/mL, P =.013). Trends towards a decrease in levels of TNF-alpha and soluble receptor 1 were also seen in the bike group only. No change in circulating inflammatory markers was observed after stimulator training.
  
  
  CONCLUSIONS
  Physical training improves exercise capacity for patients with chronic heart failure but degree of attenuation of the proinflammatory response may depend on the mode of training despite similar improvements in exercise capacity.
authors.affiliation: Cardiology Department, Centre for Cardiovascular Research, Edinburgh, United Kingdom. lemaitre@ed.ac.uk
authors.forename: John P
authors.initials: JP
authors.lastname: LeMaitre
authors.forename: Stuart
authors.initials: S
authors.lastname: Harris
authors.forename: Keith A A
authors.initials: KA
authors.lastname: Fox
authors.forename: Martin
authors.initials: M
authors.lastname: Denvir
mesh_terms: D000368:Aged; D015703:Antigens, CD / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D002303:Cardiac Output, Low / Q000097:blood* / Q000534:rehabilitation; D002908:Chronic Disease; D005080:Exercise Test; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D018124:Receptors, Tumor Necrosis Factor / Q000097:blood; D047888:Receptors, Tumor Necrosis Factor, Type I; D047889:Receptors, Tumor Necrosis Factor, Type II; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*; D016138:Walking
chemical_list: D015703:Antigens, CD; D015415:Biomarkers; D015850:Interleukin-6; D018124:Receptors, Tumor Necrosis Factor; D047888:Receptors, Tumor Necrosis Factor, Type I; D047889:Receptors, Tumor Necrosis Factor, Type II; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein