Exercise Pathophysiology Research Laboratory, Cardiology Division, Hospital de Clínicas de Porto Alegre. Porto Alegre, Rio Grande do Sul, Brazil.
Exercise Pathophysiology Research Laboratory, Cardiology Division, Hospital de Clínicas de Porto Alegre. Porto Alegre, Rio Grande do Sul, Brazil; Faculdades Integradas de Taquara, Taquara, Rio Grande do Sul, Brazil.
Am J Cardiol. 2022 Sep 1;178:60-71. doi: 10.1016/j.amjcard.2022.05.012. Epub 2022 Jul 8.
Physical training has been reported to attenuate myocardial stress and inflammation in heart failure (HF). We aimed to assess the impact of physical training on B-type natriuretic peptide and N-terminal pro-B-type natriuretic peptide (NT-proBNP), as well as biomarkers of inflammation-C-reactive protein, tumor necrosis factor α (TNF-α), and interleukins (ILs). A systematic electronic literature search was conducted up to May 2021 in PubMed, Cochrane Library, CINAHL, Embase, and SPORTDiscus to identify randomized clinical trials reporting associations between any formal physical training intervention and biomarker levels in patients with HF. Random-effects meta-analyses was used to calculate pooled correlations between physical training and blood biomarkers. Biomarker outcomes were expressed as mean difference or ratio of means and 95% confidence interval between the intervention and control groups, according to the normality of the data. A total of 38 trials were included in the final meta-analysis (2,652 randomized patients). Physical training was associated with decreased B-type natriuretic peptide (p = 0.02), NT-proBNP (p <0.01), C-reactive protein (p <0.00001), TNF-α (p = 0.03), IL-6 (p = 0.04), and IL-1β (p = 0.001). Aerobic continuous training was associated with a 35% reduction in NT-proBNP (p = 0.01); ≥150 min/week of exercise was associated with a greater reduction in TNF-α levels (p = 0.0004), and aerobic interval training was associated with lower IL-6 levels (p = 0.01). In conclusion, physical training in patients with HF is associated with beneficial effects on natriuretic peptides and biomarkers of inflammation because they were all reduced by the intervention.
身体训练已被报道可减轻心力衰竭（HF）中的心肌应激和炎症。我们旨在评估身体训练对 B 型利钠肽和 N 末端 B 型利钠肽（NT-proBNP）的影响，以及炎症标志物 C 反应蛋白、肿瘤坏死因子 α（TNF-α）和白细胞介素（ILs）。系统的电子文献检索于 2021 年 5 月前在 PubMed、Cochrane 图书馆、CINAHL、Embase 和 SPORTDiscus 中进行，以确定报告任何形式的身体训练干预与 HF 患者生物标志物水平之间关联的随机临床试验。使用随机效应荟萃分析计算身体训练与血液生物标志物之间的汇总相关性。根据数据的正态性，生物标志物结果表示为干预组和对照组之间的均值差异或均值比及其 95%置信区间。共有 38 项试验纳入最终的荟萃分析（2652 名随机患者）。身体训练与 B 型利钠肽（p = 0.02）、NT-proBNP（p <0.01）、C 反应蛋白（p <0.00001）、TNF-α（p = 0.03）、IL-6（p = 0.04）和 IL-1β（p = 0.001）的降低相关。有氧连续训练与 NT-proBNP 降低 35%（p = 0.01）相关；每周运动≥150 分钟与 TNF-α水平的降低幅度更大相关（p = 0.0004），而有氧间歇训练与 IL-6 水平降低相关（p = 0.01）。总之，HF 患者的身体训练与利钠肽和炎症标志物的有益效果相关，因为这些标志物都因干预而降低。
