Exercise May Improve Wasting in Heart Patients
Tue September 02, 2003 05:57 PM ET

NEW YORK (Reuters Health) - Aerobic exercise reduces levels of inflammatory factors in the skeletal muscles of patients with chronic heart failure, researchers report in the Journal of the American College of Cardiology.

These local anti-inflammatory effects of exercise may reduce the skeletal muscle wasting seen in patients with chronic heart failure, researchers suggest.

"For patients with stable chronic heart failure, regular aerobic exercise training should not be regarded as rehabilitation only, but as a continuing treatment with the potential to modify the underlying disease process," Dr. Stephan Gielen of the University of Leipzig Heart Center in Germany said in a statement.

Gielen and colleagues randomly assigned 20 men with stable chronic heart failure to a control group or to an exercise-training group for 6 months. Men in the training group participated in group workouts and rode a stationary bicycle daily for 20 minutes at workloads corresponding to 70% of maximal oxygen uptake.

At the start of the study, local expression of inflammatory factors called cytokines was significantly increased in skeletal muscle compared with blood levels of these cytokines, which were only slightly higher than normal.

There were no changes in cytokine levels in the control group.

Consistent with previous reports, exercise training also improved peak oxygen uptake by 29%.

"Taken together, these results indicate that long-term aerobic endurance training in chronic heart failure patients has anti-inflammatory effects on the skeletal muscle," Gielen and colleagues write. The local anti-inflammatory effects of exercise may reduce the wasting process of wasting that occurs as chronic heart failure progresses.

In an editorial, two researchers say this study offers the "interesting possibility that inflammatory mediators contribute to the skeletal muscle fatigue that plagues patients with heart failure."

"Here's a new biochemical pathway that has not been studied," said Dr. Douglas L. Mann of the Baylor College of Medicine in Houston in a statement. Because these pathways can be altered by therapeutic interventions, he suggests that anti-inflammatory strategies might be useful for treating wasting in heart failure patients.

SOURCE: Journal of the American College of Cardiology, September 3, 2003.

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