Abstract 20526: Adiponectin and High Sensitive C Reactive Protein are Reduced by Ether Low or High Intensity Exercise Training in Chronic Heart Failure: A Prospective Randomized Controlled Study
Background: Recent studies have shown that increased circulating levels of adiponectin (AD) and high sensitive C reactive protein (hs-CRP) were associated with higher mortality in chronic heart failure (CHF) patients (pts). Exercise training improves functional capacity, however, there are concerns regarding what exercise training intensity is better to improve inflammatory markers and overload hormones evaluated by brain natriuretic peptide (BNP) in CHF.
Methods: 30 men, 54 ± 2 yrs (mean ± se), with non-ischemic dilated cardiomyopathy, functional class II-III, LVEF 28 ± 1%, peak oxygen consumption (VO2) = 17,4 ± 0,6 ml/kg/min were randomized into 3 groups: low intensity exercise training (LO) - 9 pts, high intensity exercise training (HI) -11 pts, and control (CO) - 10 pts, under optimal medical treatment. At baseline and at 6 months, all pts underwent maximal treadmill cardiopulmonary exercise testing, rest and peak BNP, rest hs-CRP and AD level and rest echocardiography (echo). Low intensity training was prescribed using the heart rate corresponding to that immediately below the anaerobic threshold (67 ± 3% of peak VO2) and HI the HR immediately below the respiratory compensation point (88 ± 2% of peak VO2).
Results: Significant diferences from baseline are in the table (* = p<0,05, ** = p<0,01). AD reduced similarly in HI and LO but not in CO group (p<0.0001 interaction = 0.028) and also hs-CRP (p<0.00001 interaction = 0.038). BNP level reduced only in the LO group. Peak VO2 improved in both exercise groups. Cardiac function or dimensions by echo did not change in any group.There was a negative correlation between hs-CRP level and VO2 (r=0.46 p=0.012).
Conclusions: HI and LO enhanced maximal functional capacity and reduced AD and hs-CRP circulating levels but only the LO reduced BNP level. LO is at least as efficacious as HI program and would be stimulated in CHF patients. Peak = peak exercise.
- © 2010 by American Heart Association, Inc.