Comparative Efficacy of Various Exercise Modes on Inflammatory Markers in Patients with Heart Failure: A Pairwise and Network Meta-Analysis.
Mousa Khalafi, Saeid Fatolahi, Michael E Symonds et al.
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In 30 seconds
This systematic review and pairwise and network meta-analysis compared exercise modes for reducing inflammatory markers in patients with heart failure with reduced or preserved ejection fraction. It included 21 randomized trials involving 1022 patients. Compared with controls, exercise training was associated with lower IL-6 (SMD -0.33, 95% CI -0.56 to -0.11, P = 0.003), TNF-α (SMD -0.17, 95% CI -0.34 to -0.00, P = 0.04), and CRP (SMD -0.57, 95% CI -1.02 to -0.13, P = 0.01). Resistance training was likely most effective for IL-6; combined training was optimal for TNF-α and CRP.
Key findings
- Across exercise modes, IL-6 was lower than with control (SMD -0.33, 95% CI -0.56 to -0.11, P = 0.003).
- Exercise training reduced TNF-α (SMD -0.17, 95% CI -0.34 to -0.00, P = 0.04) and CRP (SMD -0.57, 95% CI -1.02 to -0.13, P = 0.01) versus control.
- Resistance training was likely most effective for IL-6 (SMD -0.91, 95% CI -1.32 to -0.49, P = 0.001); combined training was optimal for CRP (SMD -1.34, 95% CI -2.28 to -0.40, P = 0.004).
Why it matters
Chronic low-grade inflammation is a relevant biological feature in heart failure, and this analysis suggests exercise training can reduce several measured proinflammatory markers. The comparisons also indicate that effects may differ by exercise mode and marker. These findings help frame exercise as a potential contributor to inflammatory improvement, while biomarker changes alone do not establish effects on symptoms or clinical outcomes.
What to keep in mind
The authors advise caution because of heterogeneity and the limited number of studies.