Heart Failure Reviews

, Volume 23, Issue 2, pp 209–223 | Cite as

Effect of aerobic and resistance training on inflammatory markers in heart failure patients: systematic review and meta-analysis

  • M. J. Pearson
  • S. F. Mungovan
  • N. A. Smart


Elevated levels of pro-inflammatory markers are evident in patients with heart failure and are associated with disease severity and prognosis. Exercise training has been shown to reduce circulating levels of pro-inflammatory cytokines and other pro-inflammatory markers in healthy and clinical populations. The aim of the systematic review and meta-analysis was to investigate the effect of aerobic (AT) and resistance training (RT) interventions on circulating concentrations of inflammatory markers; tumour necrosis factor-alpha (TNF-α), interleukin 6 (IL-6), C-reactive protein (CRP), fibrinogen, soluble intercellular adhesion molecule (sICAM) and soluble vascular adhesion molecule (sVCAM) in heart failure patients. We conducted database searches (PubMed, EMBASE and Cochrane Trials Register to 30 June 2017) for exercise-based trials in heart failure, using the following search terms: exercise training, inflammation, tumour necrosis factor-alpha, interleukin 6, C-reactive protein, fibrinogen, soluble intercellular adhesions molecule-1, soluble vascular adhesion molecule-1. Twenty studies, representing 18 independent trials, were included in the review. Pooled data of six studies indicated a minimally favourable effect of exercise training on circulating TNF-α [SMD 0.42 (95% CI 0.15, 0.68), p = 0.002)]. However, together the pooled and descriptive analyses failed to provide strong evidence for a reduction in other pro-inflammatory markers. However, given the complexity of heart failure and the pathways involved in the immune and inflammatory process, large prospective trials considering aetiology, comorbidities and local skeletal muscle inflammation are required to elucidate on the anti-inflammatory effect of exercise in this population.


Heart failure Inflammatory markers TNF-α IL-6 CRP Fibrinogen sVCAM-1 sICAM-1 



M.J Pearson is supported by an Australian Postgraduate Award Scholarship. This work received no other financial support and has no relationship to industry.

Compliance with ethical standards

Conflict of interest

The authors report no relationships that could be construed as a conflict of interest.

Supplementary material

10741_2018_9677_MOESM1_ESM.docx (54 kb)
ESM 1 (DOCX 53 kb)
10741_2018_9677_MOESM2_ESM.docx (47 kb)
ESM 2 (DOCX 47 kb)


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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.School of Science and TechnologyUniversity of New EnglandArmidaleAustralia
  2. 2.Westmead Private Physiotherapy Services and The Clinical Research InstituteSydneyAustralia
  3. 3.Department of Physiotherapy, Faculty of Medicine, Dentistry and Health SciencesThe University of MelbourneMelbourneAustralia

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