Cardiac troponins decreased after exercise training in chronic heart failure

Abstract

Background: Cardiac rehabilitation is recognized as a key component of Chronic Heart Failure (CHF) management. In the other hand, it is well established that some biomarkers like as Brain Natriuretic Protein (BNP) and C - Reactive Protein (CRP), decrease after an Exercise Training Program (ETP). However, the impact of ETP on Cardiac Troponin in CHF is still unknown. Aim of study: To evaluate the changes on cardiac Troponin I (cTn I) serum levels induced by exercise training in patients with CHF. Methods: We included prospectively 81 consecutive patients: 30 cases with ischemic cardiomyopathy (CMD) and 51cases with non-ischemic CMD. Mean age was 55.5±12.2 years and 71.6% of patients were male. NYHA functional was class I in 12%, class II in 59% and class III in 29% of patients and LVEFwas<40% in all cases. We performed a complete evaluation pre- and post ETP including CPX, echocardiography, measure of BNP, CRP, creatinine and cTnI. Patients performed 20 sessions using aerobic bicycle exercise and calisthenics during 1 hour per day and five times per week. The pharmacological treatment was unchanged during the ETP Results: Table 1 illustrates the changes of cardiac and non-cardiac parameters after ETP in both ischemic and non-ischemic DCM. The mean gain of exercise capacity evaluated by peak VO2 was 1.2 ml/kg/min = 16.6% and 20% on Anaerobic Threshold (AT). Changes on cTnI were significantly correlated with LV EF. (Tabel Presented) Conclusion: According to our study, we conclude first of all that C TnI decreases significantly after ETP in both ischemic and non-ischemic DCM. Secondly, changes on CTnI are correlated with LVEF The mechanisms of this reduction are not well known, but it is probably due to a specific effect on myocardium in addition to peripheral modifications.