Effects of exercise-based cardiac rehabilitation on inflammatory biomarkers in patients with cardiovascular disease:a systematic review with meta-analysis

摘要

Background:Evidence supports the anti-inflammatory effect of exercise-based cardiac rehabilitation(CR)in patients with cardiovascular disease(CVD).Nonetheless,the influence of training variables on the effects of exercise training is debateable.Therefore,this systematic review with meta-analysis aims to i)estimate the effects of exercise-based CR on the circulating levels of inflammatory biomarkers in patients with CVD based on the type of exercise,and ii)analyse the influence of other potential moderator variables.Methods:Electronic searches were performed in PubMed,Scopus,and Web of Science databases up to October 2022.A random-effects models of standardised mean difference(SMD)were used.Subgroup analyses and meta-regressions were used to carry out heterogeneity analyses.Results:Aerobic exercise diminished the levels of C-reactive protein compared with the control group in patients with CVD(SMD+=-0.33[95%CI=-0.47,-0.20),as well as the levels of tumor necrosis factor-alfa exclusively in patients with chronic heart failure(SMD+=-0.38[95%CI=-0.59,-0.17]).Moreover,heterogeneity analyses showed that the effect of aerobic exercise on vascular cell adhesion molecule-1 is higher in studies that carried out a CR programme based exclusively on exercise,as well as in studies that performed a shorter intervention period or carried out a lower number of exercise sessions(P≤0.05).Conclusion:Our findings support the anti-inflammatory effect of aerobic exercise in patients with CVD.The low number of studies testing interventions using resistance or combined exercise precludes a definitive answer about their anti-inflammatory effects in this patient population.