Effect of Exercise Training on Interleukin-6, Tumour Necrosis Factor Alpha and Functional Capacity in Heart Failure

Abstract

Background: We pooled data from four studies, to establish whether exercise training programs were able to modulate systemic cytokine levels of tumour necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6). A second aim was to establish if differences in ExT regimens are related to degree of change in cytokines and peak VO₂. Methods: Data from four centres relating to training protocol, exercise capacity, and cytokine measures (TNF-alpha and IL-6) were pooled for analysis. Results: Data for 106 CHF patients were collated (98 men, age 62 ± 10 yrs, wt 79 ± 14 Kg). Patients were moderately impaired (peak VO₂ 16.9 ± 4.4 mls/kg/min), with moderate LV systolic dysfunction (EF 30 ± 6.9%), 78% (83) had ischaemic cardiomyopathy. After ExT, peak VO₂ increased 1.4 ± 3.4 ml/kg/min (P<.001), serum TNF-alpha decreased 1.9 ± 8.6 pg/ml (P=.02) and IL-6 was not significantly changed (0.5 ± 5.4 pg/ml, P=.32) for the whole group. Baseline and post-training peak VO₂ changes were not correlated with change in cytokine levels. Conclusions: Exercise training reduces levels TNF-alpha but not IL-6 in CHF. However, across a heterogenic patient group, change in peak VO₂ was not correlated with alterations in cytokine levels. While greater exercise volume (hours) was superior in improving peak VO₂, no particular characteristic of ExT regimes appeared superior in effecting change in serum cytokines.