Exercise training decreases plasma levels of soluble CD40 ligand and P-selectin in patients with chronic heart failure.
BACKGROUND
Inflammation may contribute to the pathogenesis of chronic heart failure. Some reports suggesting that exercise training may have net anti-inflammatory effects in heart failure patients exists, although the results are somewhat conflicting.


METHODS
Fifteen patients with mild to moderate chronic heart failure underwent an exercise training program of 20 weeks. They were examined at baseline, at the end of the training period, and 1 year after end of training.


RESULTS
Our main findings were as follows: (i) during the training period there was a significant increase in exercise capacity as estimated by the 6-min walk test as well as an improvement in several quality of life parameters, (ii) these changes were accompanied by a marked decrease in plasma levels of soluble CD40 ligand and P-selectin, probably reflecting an attenuated platelet-mediated inflammation, (iii) in contrast, there were no changes in plasma levels of tumor necrosis factor alpha, monocyte chemoattractant protein-1, or vascular cellular adhesion molecule-1 during the training period, (iv) except for an increase in systolic annular velocity there were no changes in echocardiographic variables during the training period, (v) one year after the training, in a period without systematic training, plasma levels of soluble CD40 ligand, and P-selectin had returned to baseline levels along with a nonsignificant reduction in 6-min walk test.


CONCLUSIONS
Our findings suggest a potent downregulatory effect of exercise training on platelet-mediated inflammation in patients with chronic heart failure. Further studies are needed to clarify the clinical significance of these findings.
Bjørnstad
Hans H
HH
Department of Heart Disease, Haukeland University Hospital, Bergen, Norway. habj@helse-bergen.no
Bruvik
Jannicke
J
Bjørnstad
Asne B
AB
Hjellestad
Berith L
BL
Damås
Jan K
JK
Aukrust
Pål
P
D000704:Analysis of Variance; D023201:CD40 Ligand / Q000097:blood*; D002908:Chronic Disease; D015536:Down-Regulation; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019007:P-Selectin / Q000097:blood*; D011788:Quality of Life
D019007:P-Selectin; D023201:CD40 Ligand