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The effect of concurrent aerobic-resistance training on NT-proBNP level, blood pressure and body composition of patients with chronic heart failure
Zahra Mahmoodi , Ramin Shabani * , Zahra Hojjati-ZiDashti , Mahboubeh Gholipour
Department of Physical Education and Sport Sciences, Faculty of Humanities, Rasht Branch, Islamic Azad University, Rasht, I. R. Iran. , shabani_msn@yahoo.com
Abstract:   (197 Views)
Background: Heart failure is associated with structural and functional changes of the heart and physical activity is a likely intervention to improve it. This study aimed to investigation of the effect of concurrent aerobic-resistance exercise training on NT-proBNP levels, blood pressure and body composition in patients with chronic heart failure.
Materials and Methods: In this clinical trial study, 76 patients with chronic heart failure Grade II and III, classifications of the New York Heart Association, EF≤ 40% and age range (72±7 years) randomly were divided in two equal intervention and control groups. The exercise protocol included aerobic exercises (50-85% maximum heart rate) and resistance training (50-70% one repeated maximum) for 2 months, three times a week. Blood pressure, body composition and serum NT-pro BNP levels were measured before and 8 weeks after.   
Results: Eight weeks of combined exercise caused significantly reduced in weight, BMI, WHR, Heart Rate and NT-proBNP in the intervention group (P<0.05). But, WHR and BMI was no significant difference in between groups in post-test. Also, significant changes were not observed in blood pressure and mean arterial pressure within and between groups.
Conclusion: It seems, combined exercises training were effective in reducing weight and NT-proBNP, Therefore, the present training program can be proposed as non-pharmaceutical interventions for patients with heart failure.
Keywords: Combined training, NT-pro BNP, Congestive Heart Failure, Body composition, Blood Pressure
     
Type of Study: Research | Subject: medicine, paraclinic
Received: 2018/12/17 | Accepted: 2019/04/24
References
1. Savarese G, Lund LH. Global public health burden of heart failure. Cardiac Fail Rev 2017; 3(1): 7–11.
2. Piepoli MF, Conraads V, CorrÁ U, Dickstein K, Francis DP, Jaarsma T, et al. Exercise training in heart failure: From theory to practice. A consensus document of the Heart Failure Association and the European Association for Cardiovascular Prevention and Rehabilitation. Eur J Heart Fail 2011; 13(4): 347–57.
3. Fassett RG, Venuthurupalli SK, Gobe GC, Coombes JS, Cooper MA, Hoy WE. Biomarkers in chronic kidney disease: A review. Kidney Int 2011; 80: 806–21.
4. Stanek B, Frey B, Hülsmann M, Berger R, Sturm B, Strametz-Juranek J, et al. Prognostic evaluation of neurohumoral plasma levels before and during beta-blocker therapy in advanced left ventricular dysfunction. J Am Coll Cardiol 2001; 38(2): 436–42.
5. Felker GM, Whellan D, Kraus WE, Clare R, Zannad F, Donahue M, et al. N-terminal pro-brain natriuretic peptide and exercise capacity in chronic heart failure: data from the Heart Failure and a Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION) study. Am Heart J 2009; 158(4): 37-44.
6. Raizada A, Bhandari S, Khan MA, Singh HV, Thomas S, Sarabhai V, et al. Brain type natriuretic peptide (BNP) -a marker of new millennium in diagnosis of congestive heart failure. Indian J Clin Biochem 2007; 22(1): 4-9.
7. Gaggin HK, Mohammed AA, Bhardwaj A, Rehman SU, Gregory SA, Weiner RB, et al. Heart failure outcomes and benefits of NT-proBNP-guided management in the elderly: Results from the prospective, randomized ProBNP outpatient tailored chronic heart failure therapy (PROTECT) study. J Cardic Failure 2012; 18(8): 626–34.
8. Kubanek M, Goode KM, Lanska V, Clark AL, Cleland JG.‌ The prognostic value of repeated measurement of N-terminal pro-B-type natriuretic peptide in patients with chronic heart failure due to left ventricular systolic dysfunction. Eur J Heart Failure 2009; 11(4): 367–77.
9. Rothwell PM, Howard SC, Dolan E, O’Brien E, Dobson JE, Dahlof B, et al. Prognostic significance of visit-to-visit variability, maximum systolic blood pressure, and episodic hypertension. Lancet 2010; 375(9718):895–905.
10. Nakatsu T, Shinohata R, Mashima K, Yuki Y, Nishitani A, Toyonaga S, et al. Use of plasma B-type natriuretic peptide level to identify asymptomatic hypertensive patients with abnormal diurnal blood pressure variation profiles: nondippers, extreme dippers, and risers. Hypertens Res 2007; 30(7): 651–8.
11. Conraads VM, Beckers P, Vaes J, Martin M, Van Hoof V, De Maeyer C, et al. Combined endurance/resistance training reduces NT-proBNP levels in patients with chronic heart failure. Eur Heart J 2004; 25(20): 1797–805.
12. Madamanchi C, Alhosaini H, Sumida A, Runge MS. Obesity and natriuretic peptides, BNP and NT-proBNP: mechanisms and diagnostic implications for heart failure. Int J Cardiol 2014; 176(3): 611–7.
13. Jewiss D, Ostman C, Smart NA. The effect of resistance training on clinical outcomes in heart failure: A systematic review and meta-analysis. Int J Cardiol 2016; 221:674–81.
14. Passino C, Severino S, Poletti R, Piepoli MF, Mammini C, Clerico A, et al. Aerobic training decreases B-type natriuretic peptide expression and adrenergic activation in patients with heart failure. J Am Coll Cardiol 2006; 47(9): 1835–9.
15. Giallauria F, Cirillo P, Lucci R, Pacileo M, De Lorenzo A, D’Agostino M, et al. Left ventricular remodelling in patients with moderate systolic dysfunction after myocardial infarction: Favourable effects of exercise training and predictive role of N-terminal pro-brain natriuretic peptide. Eur J Cardiovasc Prev Rehabil 2008; 15(1):113–8.
16. Pareja-Galeano H, Garatachea N, Lucia A. Exercise as a Polypill for Chronic Diseases. Prog Mol Biol Transl Sci 2015; 135: 497-526.
17. Smart NA, Meyer T, Butterfield JA, Faddy SC, Passino C, Malfatto G, et al. Individual patient meta-analysis of exercise training effects on systemic brain natriuretic peptide expression in heart failure. Eur J Prev Cardiol 2012; 19(3): 428–35.
18. Giallauria F, Lorenzo AD, Pilerci F, Manakos A, Lucci R, Psaroudaki M, et al. Reduction of N terminal-pro-brain (B-type) natriuretic peptide levels with exercise-based cardiac rehabilitation in patients with left ventricular dysfunction after myocardial infarction. Eur J Cardiovasc Prev Rehabil 2006; 13(4):625-632.
19. Erbs S, Höllriegel R, Linke A, Beck EB, Adams V, Gielen S, et al. Exercise training in patients with advanced chronic heart failure (NYHA IIIb) promotes restoration of peripheral vasomotor function, induction of endogenous regeneration, and improvement of left ventricular function. Circ Heart Fail 2010; 3(4): 486-94.
20. Hambrecht R, Adams V, Erbs S, Linke A, Kränkel N, Shu Y, et al. Regular physical activity improves endothelial function in patients with coronary artery disease by increasing phosphorylation of endothelial nitric oxide synthase. Circulation 2003; 107(25): 3152-8.
21. Cittadini A, Monti MG, Iaccarino G, Castiello MC, Baldi A, Bossone E, et al. SOCS1 gene transfer accelerates the transition to heart failure through the inhibition of the gp130/JAK/STAT pathway. Cardiovasc Res 2012; 96(3): 381-90.
22. Pescatello LS, Franklin BA, Fagard R, Farquhar WB, Kelley GA, Ray CA, American College of Sports Medicine American College of Sports Medicine position stand. Exercise and hypertension. Med Sci Sports Exerc 2004; 36(3): 533–53.
23. Myers J. Cardiology patient pages. Exercise and cardiovascular health. Circulation 2003; 107: e2–e5.
24. Ahmad T, Fiuzat M, Mark DB, Neely B, Neely M, Kraus WE, et al. The effects of exercise on cardiovascular biomarkers in patients with chronic heart failure. Am Heart J 2014; 167(2): 193-202. e1.
25. Nilsson BB, Westheim A, Risberg MA, Arnesen H, Seljeflot I. No effect of group-based aerobic interval training on N-terminal pro- B-type natriuretic peptide levels in patients with chronic heart failure. Scandinavian Cardiovascular J 2010; 44(4): 223-9.
26. Ferguson S, Gledhill N, Jamnik VK, Wiebe C, Payne N. Cardiac performance in endurance-trained and moderately active young women. Med Sci Sports Exerc 2001; 33(7): 1114–9.
27. Wisloff U, Najjar SM, Ellingsen O, Haram PM, Swoap S, Al-Share Q, et al. Cardiovascular risk factors emerge after artificial selection for low aerobic capacity. Science 2005; 307(5708):418–20.
28. Maiorana A, O'Driscoll G, Cheetham C, Collis J, Goodman C, Rankin S, et al. Combined aerobic and resistance exercise training improves functional capacity and strenght in CHF. J Appl Physiol 2000; 88(5): 1565-70.
29. Maiorana A, O'Driscoll G, Dembo L, Cheetham C, Goodman C, Taylor R, et al. Effect of aerobic and resistance exercise training on vascular function in heart failure. Am J Physiology-Heart Circulatory Physiol 2000; 279(4): H1999-H2005.
30. Taylor RS, Sagar VA, Davies EJ, Briscoe S, Coats AJ, Dalal H, et al. Exercise‐based rehabilitation for heart failure. Cochrane Database Systematic Reviews 2014(4).
31. Pearson MJ, Smart NA. Exercise therapy and autonomic function in heart failure patients: a systematic review and meta-analysis. Heart Fail Rev 2018; 23(1):91-108.
32. Gary RA, Cress ME, Higgins MK, Smith AL, Dunbar SB. A combined aerobic and resistance exercise program improves physical functional performance in patients with heart failure: a pilot study. J Cardiovas Nurs 2012; 27(5):418.
33. Dean A, Sciences H, Kingston RI, Island R, Edith PC, Heart BF, et al. ACSM”S Guidelines for Exercise Testing and Prescription. 10th ed. Philadelphia: American College of Sports Medicine, Wolters Kluwer Health; 2018. p. 249.
34. Sturm B, Quittan M, Wiesinger GF, Stanek B, Frey B, Pacher R. Moderate-intensity exercise training with elements of step aerobics in patients with severe chronic heart failure. Arch Phys Med Rehabil 1999; 80(7): 746–50.
35. Godsen R, Carroll T, Stone S. How well does the Polar Vantage XL heart rate monitor estimate actual heart rate? Med Sci Sports Exerc 1991; 23(4):14.
36. Leger L, Thivierge M. Heart rate monitors: validity, stability and functionality. Phys Sports Med 1988; 16(5):143–51.
37. Borg G. Borg’s Perceived Exertion and Pain Scales. Champaign, IL: Human Kinetics; 1998.
38. Borg G. Psychophysical bases of perceived exertion. Med Sci Sports Exerc 1982; 14(5): 377–81.
39. Giuliano C, Karahalios A, Neil C, Allen J, Levinger I. The effects of resistance training on muscle strength, quality of life and aerobic capacity in patients with chronic heart failure—A meta-analysis. Int J Cardiol 2017; 227: 413–23.
40. Rengo G, Parisi V, Femminella GD, Pagano G, de Lucia C, Cannavo A, et al. Molecular aspects of the cardio protective effect of exercise in the elderly. Aging Clin Experimental Res 2013; 25(5): 487-97.
41. Gastelurrutia P, Nescolarde L, Rosell Ferrer J, et al. Bioelectrical impedance vector analysis (BIVA) in stable and nonstable heart failure patients: a pilot study. Int J Cardiol 2011; 146(2): 262-4.
42. Belardinelli R, Georgiou D, Cianci G, Purcaro A. Randomized, Controlled Trial of Long-Term Moderate Exercise Training in Chronic Heart Failure. Circulation 1999; 99(9): 1173-82.
43. Belardinelli R, Georgiou D, Cianci G, et al. Exercise training improves left ventricular diastolic filling in patients with dilated cardiomyopathy. Circulation 1995; 91(11): 2775-84.
44. Giannuzzi P, Temporelli PL, Corrà U, Tavazzi L. Antiremodeling Effect of Long-Term Exercise Training in Patients With Stable Chronic Heart Failure. Circulation 2003; 108(5): 554-9.
45. Volaklis KA, Tokmakidis SP. Resistance Exercise Training in Patients with Heart Failure. Sports Med 2005; 35(12): 1085-103.
46. Franklin BA, Bonzheim K, Gordon S, Timmis GC. Resistance training in cardiac rehabilitation. J Cardiopulm Rehabil 1991; 11(2): 99-107
47. Rehabilitation M. Resistance Training for Cardiac Patients. Hypertension 2008; 12(6): 22–8.
48. Caminiti G, Volterrani M, Marazzi G, Cerrito A, Massaro R, Arisi A, et al. Tai Chi Enhances the Effects of Endurance Training in the Rehabilitation of Elderly Patients with Chronic Heart Failure. Rehabili Res Practice 2011; 2011: 1-6.
49. Lu WA, Kuo CD. The effect of Tai Chi Chuan on the autonomic nervous modulation in older persons. Med Sci Sports Exerc 2003; 35(12): 1972–6.
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