Acute and chronic effects of exercise on inflammatory markers and B-type natriuretic peptide in patients with coronary artery disease.
BACKGROUND
Few studies have prospectively addressed the effects of exercise in the inflammatory activity of patients with coronary artery disease (CAD). We sought to evaluate the consequences of an acute bout of exercise on inflammatory markers and BNP in untrained CAD patients before and after randomization to a training program.


METHODS
34 CAD patients underwent a 50-min acute exercise session on a cycle-ergometer at 65% peak oxygen uptake before and after blood sampling. They were then randomized to a 4-month chronic exercise program (15 patients) or general lifestyle recommendations (19 patients), undergoing a new acute session of exercise after that.


RESULTS
In the overall population, acute exercise caused a significant increase in C-reactive protein [CRP; 1.79 (4.49) vs. 1.94 (4.89) mg/L, P < 0.001], monokine induced by interferon-γ [Mig; 351 (324) vs. 373 (330) pg/mL, P = 0.027] and vascular adhesion molecule-1 [VCAM-1; 226 (82) vs. 252 (110) pg/mL, P = 0.02]. After 4-months, in exercise-trained patients, there was a significant decrease in the inflammatory response provoked by the acute exercise compared to patients in the control group reflected by a significant decrease in the differences between rest and post-exercise levels of CRP [-0.29 (0.84) mg/L vs. -0.11 (0.21) mg/L, P = 0.05]. Resting BNP was also significantly lower in exercise-trained patients when compared to untrained controls [15.6 (16.2) vs. 9.7 (11.4) pg/mL, P = 0.04 and 19.2 (27.8) vs. 23.2 (27.5) pg/mL, P = 0.76; respectively].


CONCLUSIONS
Chronic exercise training might partially reverse the inflammatory response caused by acute exercise in CAD patients. These results suggest that regular exercise is an important nonpharmacological strategy to the improvement in inflammation in CAD patients.
Lara Fernandes
Juliano
J
University of Campinas (Unicamp), R. Antonio Lapa 1032, Campinas, SP, 13025-242, Brazil. jlaraf@fcm.unicamp.br
Serrano
Carlos Vicente
CV
Toledo
Flavia
F
Hunziker
Maria Fernanda
MF
Zamperini
Augusto
A
Teo
Fabio H
FH
Oliveira
Romulo T
RT
Blotta
Maria Heloisa
MH
Rondon
Maria Urbana
MU
Negrão
Carlos Eduardo
CE
D000208:Acute Disease; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications / Q000503:physiopathology*; D016207:Cytokines / Q000097:blood*; D015444:Exercise; D005080:Exercise Test; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*
D015415:Biomarkers; D016207:Cytokines; D020097:Natriuretic Peptide, Brain