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Addition of strength training modifies the aerobic exercise inflammatory response in heart failure patients – Comments on the underlying pathophysiology


Published: Apr 5, 2022
Keywords:
Heart failure rehabilitation inflammatory response exercise training strength training
Dimitrios Delis
Vasiliki Linardatou
Eleftherios Karatzanos
Chris Kourek
Anastasios Philippou
Dimitrios Vagionas
Niki Panagopoulou
Manal Alshamari
Theodoros Pittaras
Serafim Nanas
Ioannis Vasileiadis
Abstract

Aim: The present study investigates the effect of Strength Training addition in a High Intensity Interval Training (HIIT) program, on the inflammatory profile of chronic heart failure (CHF) patients.


Materials and Methods: Forty-six CHF patients were randomized into the two different exercise rehabilitation groups. A patient group (control) performed HIIT and another group performed Combined (HIIT and strength training) Exercise Training (COM) for a three- month period. Before and after rehabilitation, all patients performed a maximal cardiopulmonary exercise testing (CPET). Microcirculatory parameters were assessed by Near Infrared Spectroscopy; CRP, IL-2, IL-6, IL-10 and VEGF levels were measured in plasma.


Results: Cardiopulmonary parameters and microcirculatory indices improved after rehabilitation. CRP and the IL-6/IL-10 ratio decreased after rehabilitation. By linear regression analysis, a negative correlation was noted between IL-2, IL-6 and IL-10 changes (post-CPET values) and the VE/VCO2 slope change, for the entire patient cohort. The correlation was separately maintained only in the COM group.


Conclusions: Overall, the results of the present study reinforce the view of an anti-inflammatory effect of exercise in CHF patients. The significant correlations demonstrated between the cytokine responses and the ventilatory response to exercise, particularly in the COM group, probably ensue from the special effect of strength training on peripheral muscle function.

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References
Gunn E, Smith KM, McKelvie RS, Arthur HM. Exercise and the heart failure patient: aerobic vs strength training--is there a need for both? Progress in Cardiovascular Nursing 2006;21(3):146-50.
Hendrickse P, Degens H. The role of the microcirculation in muscle function and plasticity. Journal of Muscle Research And Cell Motility 2019;40(2):127-40.
Van Linthout S, Tschöpe C. Inflammation - Cause or Consequence of Heart Failure or Both? Current Heart Failure Reports 2017;14(4):251-65.
Helge JW, Stallknecht B, Pedersen BK, Galbo H, Kiens B, Richter EA. The effect of graded exercise on IL-6 release and glucose uptake in human skeletal muscle. The Journal of Physiology 2003;546(Pt 1):299-305.
Gielen S, Adams V, Möbius-Winkler S, Linke A, Erbs S, Yu J, et al. Anti-inflammatory effects of exercise training in the skeletal muscle of patients with chronic heart failure. Journal of the American College of Cardiology 2003;42(5):861-8.
Gerovasili V, Drakos S, Kravari M, Malliaras K, Karatzanos E, Dimopoulos S, et al. Physical exercise improves the peripheral microcirculation of patients with chronic heart failure. Journal of Cardiopulmonary Rehabilitation and Prevention 2009;29(6):385-91.
Zwetsloot KA, John CS, Lawrence MM, Battista RA, Shanely RA. High-intensity interval training induces a modest systemic inflammatory response in active, young men. Journal of Inflammation Research 2014;7:9-17.
Coyle EF. Very intense exercise-training is extremely potent and time efficient: a reminder. Journal of Applied Physiology (Bethesda, Md : 1985) 2005;98(6):1983-4.
Gibala MJ, Little JP, van Essen M, Wilkin GP, Burgomaster KA, Safdar A, et al. Short-term sprint interval versus traditional endurance training: similar initial adaptations in human skeletal muscle and exercise performance. The Journal of Physiology2006;575(Pt 3):901-11.
Gaesser GA, Angadi SS. High-intensity interval training for health and fitness: can less be more? Journal of applied physiology (Bethesda, Md : 1985) 2011;111(6):1540-1.
Gerovasili V, Dimopoulos S, Tzanis G, Anastasiou-Nana M, Nanas S. Utilizing the vascular occlusion technique with NIRS technology. International Journal of Industrial Ergonomics 2010;40(2):218-22.
Linardatou V, Karatzanos E, Panagopoulou N, Delis D, Kourek C, Rovina N, et al. Passive smoking acutely affects the microcirculation in healthy non-smokers. Microvascular Research 2020;128:103932.
Fisher RA. Statistical Methods for Research Workers. Oliver and Boyd. 1925.
B. B. BD Cytometric Bead Array (CBA) Human Soluble Protein Master Buffer Kit Instruction Manual: Becton, Dickinson and Company BD Biosciences.
Wisløff U, Støylen A, Loennechen JP, Bruvold M, Rognmo Ø, Haram PM, et al. Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients: a randomized study. Circulation 2007;115(24):3086-94.
Way KL, Vidal-Almela S, Keast ML, Hans H, Pipe AL, Reed JL. The feasibility of implementing high-intensity interval training in cardiac rehabilitation settings: a retrospective analysis. BMC Sports Sci Med Rehabil2020;12:38.
Dun Y, Smith JR, Liu S, Olson TP. High-Intensity Interval Training in Cardiac Rehabilitation. Clinics in Geriatric Medicine. 2019;35(4):469-87.
Chen OP J, Mohamed E, Greene M, Moskovits N, Shani J. The Immunoregulatory Role of Cytokines in Conges-tive Heart Failure. Interdiscip J Microinflammation 2014;1(111).
Pedersen BK. Anti-inflammatory effects of exercise: role in diabetes and cardiovascular disease. European Journal of Clinical Investigation 2017;47(8):600-11.
Gustafsson T, Bodin K, Sylvén C, Gordon A, Tyni-Lenné R, Jansson E. Increased expression of VEGF following exercise training in patients with heart failure. European Journal Of Clinical Investigation 2001;31(4):362-6.
Agapitou V, Tzanis G, Dimopoulos S, Karatzanos E, Karga H, Nanas S. Effect of combined endurance and resistance training on exercise capacity and serum anabolic steroid concentration in patients with chronic heart failure. Hellenic Journal of Cardiology : HJC = Hellenike kardiologike epitheorese 2018;59(3):179-81.
Soares RN, Somani YB, Proctor DN, Murias JM. The association between near-infrared spectroscopy-derived and flow-mediated dilation assessment of vascular responsiveness in the arm. Microvascular Research 2019;122:41-4.
Berg OK, Kwon OS, Hureau TJ, Clifton HL, Thurston T, Le Fur Y, et al. Maximal strength training increases muscle force generating capacity and the anaerobic ATP synthesis flux without altering the cost of contraction in elderly. Experimental Gerontology 2018;111:154-61.
Karlsen T, Helgerud J, Støylen A, Lauritsen N, Hoff J. Maximal strength training restores walking mechanical efficiency in heart patients. International Journal of Sports Medicine 2009;30(5):337-42.
Massie B, Conway M, Yonge R, Frostick S, Ledingham J, Sleight P, et al. Skeletal muscle metabolism in patients with congestive heart failure: relation to clinical severity and blood flow. Circulation 1987;76(5):1009-19.
Piepoli M, Clark AL, Volterrani M, Adamopoulos S, Sleight P, Coats AJ. Contribution of muscle afferents to the hemodynamic, autonomic, and ventilatory responses to exercise in patients with chronic heart failure: effects of physical training. Circulation 1996;93(5):940-52.
Pongratz G, Straub RH. The sympathetic nervous response in inflammation. Arthritis Research & Therapy 2014;16(6):504.
Jänig W. Sympathetic nervous system and inflammation: a conceptual view. Autonomic neuroscience : basic & clinical 2014;182:4-14.
Vinogradova OL, Popov DV, Tarasova o S, Bravyĭ Ia R, Missina SS, Bersenev E, et al. [Ergoreflex: the essence and mechanisms]. Aviakosmicheskaia i ekologicheskaia meditsina = Aerospace and environmental medicine 2008;42(1):5-15.
Ratamess N, Alvar B, Evetoch T, Housh T, Kibler W. and Kraemer, W. Progression Models in Resistance Training for Healthy Adults. Medicine & Science in Sports & Exercise 2009;41:687-708.
Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal and neuromotor fitness in apparently healthy adults: Guidance for prescribing exercise. Medicine & Science in Sports & Exercise 2011;43:1334-59.
Mandic S, Myers J, Selig SE, Levinger I. Resistance versus aerobic exercise training in chronic heart failure. Current Heart Failure Reports 2012;9(1):57-64.
Pedersen BK, Febbraio MA. Muscle as an endocrine organ: focus on muscle-derived interleukin-6. Physiological Reviews 2008;88(4):1379-406.
Pedersen BK. Muscular interleukin-6 and its role as an energy sensor. Medicine and Science In Sports and Exercise 2012;44(3):392-6.
Vierck J, O'Reilly B, Hossner K, Antonio J, Byrne K, Bucci L, et al. Satellite cell regulation following myotrauma caused by resistance exercise. Cell Biology International 2000;24(5):263-72.
Yokota TK S, Yamato M, Hirabayashi K, Suga T, Takada S, Harada K, Morita N, Oyama-Manabe N, Kikuchi Y, Okita K, Tsutsui H. Systemic oxidative stress is associated with lower aerobic capacity and impaired skeletal muscle energy metabolism in pa-tients with metabolic syndrome. Diabetes Care 2013;36:1341-6.
McGarry T, Biniecka M, Veale DJ, Fearon U. Hypoxia, oxidative stress and inflammation. Free Radical Biology & Medicine 2018;125:15-24.
Hurley BF, Nemeth PM, Martin WH, 3rd, Hagberg JM, Dalsky GP, Holloszy JO. Muscle triglyceride utilization during exercise: effect of training. Journal of Applied Physiology (Bethesda, Md : 1985) 1986;60(2):562-7.
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