Aerobic Versus Concurrent Exercise on Interleukin-6 in Patients with Coronary Arterial Disease: A Systematic Review

Keywords: coronary artery disease, aerobic, concurrent, IL-6

Abstract

Aerobic exercise (AE) has been shown to be beneficial for the survival of patients with CAD and the decrease in interleukin 6 (IL-6). However, there is little evidence of the effect of concurrent training (CT). Purpose: To analyze the effect of AE versus CT on IL-6 in patients with CAD. Methodology: It was developed based on the PRISMA agreements; scientific articles were searched through electronic databases. The search terms (Boolean phrase) were the following: ("coronary artery disease" OR '' cardiac disease '' OR "cardiovascular disease") AND ('' exercise '' OR '' training '' OR "cardiac rehabilitation") AND ("IL-6" OR "Interleukin-6" OR "inflammatory markers") NOT ("animals" OR "rat"). The searches were conducted between August and December 2019. Results: A total of 2516 studies were reviewed, of which 10 studies that met the eligibility criteria were included. A total of 413 patients were analyzed. An improvement was found between 5% and 74% with the AE and between 2.3% and 58.8% with the CT. Both modalities significantly decrease IL-6, regardless of age, weekly training sessions, and the initial stage of patients with CAD; however, those studies that used a high intensity or a volume greater than 30 minutes showed greater benefits. Conclusion: Both EA and CT are beneficial in reducing IL-6 in patients with CAD. This systematic review leaves the possibility of continuing to investigate the behavior of high intensity in the decrease of IL-6.

References

Akbarpour, M. (2013). The effect of aerobic training on serum adiponectin and leptin levels and inflammatory markers of coronary heart disease in obese men. Biology of Sport, 30(1), 21-27. https://dx.doi.org/10.5604%2F20831862.1029817

Alter, D., Oh, P., & Chong, A. (2009). Relationship between cardiac rehabilitation and survival after acute cardiac hospitalization within a universal health care system. European Journal of Cardiovascular Prevention and Rehabilitation, 16(1), 102-113. https://doi.org/10.1097/HJR.0b013e328325d662

Araya-Ramírez, F., Ureña-Bonilla, P., Sánchez-Ureña, B., Blanco-Romero, L., Rodríguez-Montero, A., & Moraga-Rojas, C. (2013). Influencia de la capacidad funcional inicial en marcadores fisiológicos después de un programa de rehabilitación cardiaca. Revista Costarricense de Cardiología, 15(1), 05-11. https://www.scielo.sa.cr/pdf/rcc/v15n1/art02v15n1.pdf

Beckie, T. M., Beckstead, J. W., & Groer, M. W. (2010). The Influence of Cardiac Rehabilitation on Inflammation and Metabolic Syndrome in Women with Coronary Heart Disease. The Journal of cardiovascular nursing, 25(1), 52-60. https://doi.org/10.1097/JCN.0b013e3181b7e500

Braith, R., Welsch, M., Feigenbaum, M., Kluess, H., & Pepine, C. (1999). Neuroendocrine activation in heart failure is modified by endurance exercise training. Journal of the American College of Cardiology, 34(4), 1170-1175. https://doi.org/10.1016/s0735-1097(99)00339-3

Buchan, D., Ollis, S., Young, J., Thomas, N., Cooper, S., Tong, T., Nie, J., Malina, R., & Baker, J. (2011). The effects of time and intensity of exercise on novel and established markers of CVD in adolescent youth. American Journal of Human Biology, 23(4), 517-526. https://doi.org/10.1002/ajhb.21166

Chow, S., Maisel, A., Anand, I., Bozkurt, B., de Boer, R., Felker, G., Fonarow, G., Greenberg, B., Januzzi, J., Kiernan, M., Liu, P., Wang, T., Yancy, C., & Zile, M. (2017). Role of Biomarkers for the Prevention, Assessment, and Management of Heart Failure: A Scientific Statement from the American Heart Association. American Heart Association, 135(22), e1054-e1091. https://doi.org/10.1161/CIR.0000000000000490

Christodoulidis, G., Vittorio, T., Fudim, M., Lerakis, S., & Kosmas, C. E. (2014). Inflammation in coronary artery disease. Cardiology in Review, 22(6), 279-288. https://doi.org/10.1097/CRD.0000000000000006

Conraads, V., Beckers, P., Bosmans, J., De Clerck, L., Stevens, W., Vrints, C., & Brutsaert, D. (2002). Combined endurance/resistance training reduces plasma TNF-alpha receptor levels in patients with chronic heart failure and coronary artery disease. European Heart Journal, 23(23), 1854-1860. https://doi.org/10.1053/euhj.2002.3239

Crimi, E., Ignarro, L., Cacciatore, F., & Napoli, C. (2009). Mechanisms by which exercise training benefits patients with heart failure. Nature Reviews Ccardiology, 6(4), 292-300. https://doi.org/10.1038/nrcardio.2009.8

Del Giudice, M., & Gangestad, S. (2018). Rethinking IL-6 and CRP: Why they are more than inflammatory biomarkers, and why it matters. Brain, Behavior, and Immunity, 70, 61-75. https://doi.org/10.1016/j.bbi.2018.02.013

Dod, H., Bhardwaj, R., Sajja, V., Weidner, G., Hobbs, G. R., Konat, G. W., Manivannan, S., Gharib, W., Warden, B., Nanda, N., Beto, R., Ornish, D., & Jain, A. (2010). Effect of intensive lifestyle changes on endothelial function and on inflammatory markers of atherosclerosis. The American Journal of Cardiology, 105(3), 362-367. https://doi.org/10.1016/j.amjcard.2009.09.038

Fioranelli, M., Bottaccioli, A., Bottaccioli, F., Bianchi, M., Rovesti, M., & Roccia, M. (2018). Stress and Inflammation in Coronary Artery Disease: A Review Psychoneuroendocrineimmunology-Based. Frontiers in Immunology, 9. https://doi.org/10.3389/fimmu.2018.02031

Fleg, J., Forman, D., Berra, K., Bittner, V., Blumenthal, J., Chen, M., Cheng, S., Kitzman, D., Maurer, M., Rich, M., Shen, W., Williams, M., & Zieman, S. (2013). Secondary prevention of atherosclerotic cardiovascular disease in older adults: A scientific statement from the American Heart Association. Circulation, 128(22), 2422-2446. https://doi.org/10.1161/01.cir.0000436752.99896.22

Frostegård, J., Ulfgren, A., Nyberg, P., Hedin, U., Swedenborg, J., Andersson, U., & Hansson, G. (1999). Cytokine expression in advanced human atherosclerotic plaques: Dominance of pro-inflammatory (Th1) and macrophage-stimulating cytokines. Atherosclerosis, 145(1), 33-43. https://doi.org/10.1016/s0021-9150(99)00011-8

Fu, T., Wang, C., Lin, P., Hsu, C., Cherng, W., Huang, S., Liu, M., Chiang, C., & Wang, J. (2013). Aerobic interval training improves oxygen uptake efficiency by enhancing cerebral and muscular hemodynamics in patients with heart failure. International Journal of Cardiology, 167(1), 41-50. https://doi.org/10.1016/j.ijcard.2011.11.086

Hambrecht, R., Gielen, S., Linke, A., Fiehn, E., Yu, J., Walther, C., Schoene, N., & Schuler, G. (2000). Effects of exercise training on left ventricular function and peripheral resistance in patients with chronic heart failure: A randomized trial. JAMA, 283(23), 3095-3101. https://doi.org/10.1001/jama.283.23.3095

Haykowsky, M., Daniel, K., Bhella, P., Sarma, S., & Kitzman, D. (2016). Heart Failure: Exercise-Based Cardiac Rehabilitation: Who, When, and How Intense? The Canadian Journal of Cardiology, 32(10 Suppl 2), S382-S387. https://doi.org/10.1016/j.cjca.2016.06.001

Kim, H.-J., Oh, J.-K., Kim, C., Jee, H., Shin, K.-A., & Kim, Y.-J. (2013). Effects of six-week cardiac rehabilitation and exercise on adiponectin in patients with acute coronary syndrome. Kardiologia Polska, 71(9), 924-930. https://doi.org/10.5603/KP.2013.0227

Leon, A., Franklin, B., Costa, F., Balady, G., Berra, K. A., Stewart, K., Thompson, P., Williams, M., & Lauer, M. (2005). Cardiac rehabilitation and secondary prevention of coronary heart disease: An American Heart Association scientific statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity), in collaboration with the American association of Cardiovascular and Pulmonary Rehabilitation. Circulation, 111(3), 369-376. https://doi.org/10.1161/01.CIR.0000151788.08740.5C

Libby, P., & Theroux, P. (2005). Pathophysiology of Coronary Artery Disease. Circulation, 111(25), 3481-3488. https://doi.org/10.1161/CIRCULATIONAHA.105.537878

Lindmark, E., Diderholm, E., Wallentin, L., & Siegbahn, A. (2001). Relationship between interleukin 6 and mortality in patients with unstable coronary artery disease: Effects of an early invasive or noninvasive strategy. JAMA, 286(17), 2107-2113. https://doi.org/10.1001/jama.286.17.2107

Madjid, M., & Willerson, J. (2011). Inflammatory markers in coronary heart disease. British Medical Bulletin, 100(1), 23-38. https://doi.org/10.1093/bmb/ldr043

Marzolini, S., Oh, P., & Brooks, D. (2012). Effect of combined aerobic and resistance training versus aerobic training alone in individuals with coronary artery disease: A meta-analysis. European Journal of Preventive Cardiology, 19(1), 81-94. https://doi.org/10.1177/1741826710393197

Ministerio de Salud. (2017). Memoria Institucional-2016. Ministerio de Salud de Costa Rica. https://www.ministeriodesalud.go.cr/index.php/gestion-institucional/memoria-institucional-transparencia

Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Medicine, 6(7), e1000097. https://doi.org/10.1371/journal.pmed.1000097

Montero, D., Diaz, C., & Lundby, C. (2015). Endurance Training and VO2max: Role of Maximal Cardiac Output and Oxygen Extraction. Medicine and Science in Sports and Exercise, 47(10), 2024-2033. https://doi.org/10.1249/MSS.0000000000000640

Ohsuzu, F. (2004). The roles of cytokines, inflammation and immunity in vascular diseases. Journal of Atherosclerosis and Thrombosis, 11(6), 313-321. https://doi.org/10.5551/jat.11.313

Oldridge, N., Pakosh, M., & Grace, S. (2019). A systematic review of recent cardiac rehabilitation meta-analyses in patients with coronary heart disease or heart failure. Future Cardiology, 15(3), 227-249. https://doi.org/10.2217/fca-2018-0085

Organización Mundial de la Salud. (2018). The top 10 causes of death. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death

Panagiotakos, D. B., Kokkinos, P., Manios, Y., & Pitsavos, C. (2004). Physical Activity and Markers of Inflammation and Thrombosis Related to Coronary Heart Disease. Preventive Cardiology, 7(4), 190-194. https://doi.org/10.1111/j.1520-037X.2004.03539.x

Pérez-Fernández, R., & Kaski, J. (2002). Interleucina-10 y enfermedad coronaria. Revista Española de Cardiología, 55(7), 738-750.

Pinto, A., Di Raimondo, D., Tuttolomondo, A., Buttà, C., Milio, G., & Licata, G. (2012). Effects of physical exercise on inflammatory markers of atherosclerosis. Current Pharmaceutical Design, 18(28), 4326-4349. https://doi.org/10.2174/138161212802481192

Ponikowski, P., Voors, A., Anker, S., Bueno, H., Cleland, J., Coats, A., Falk, V., González-Juanatey, J., Harjola, V., Jankowska, E., Jessup, M., Linde, C., Nihoyannopoulos, P., Parissis, J., Pieske, B., Riley, J., Rosano, G., Ruilope, L., Ruschitzka, F., … Van der Meer, P. (2016). 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. European Journal of Heart Failure, 18(8), 891-975. https://doi.org/10.1002/ejhf.592

Reuben, D., Judd-Hamilton, L., Harris, T., & Seeman, T. (2003). The associations between physical activity and inflammatory markers in high-functioning older persons: MacArthur Studies of Successful Aging. Journal of the American Geriatrics Society, 51(8), 1125-1130. https://doi.org/10.1046/j.1532-5415.2003.51380.x

Ridker, P., Hennekens, C., Buring, J., & Rifai, N. (2000). C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. The New England Journal of Medicine, 342(12), 836-843. https://doi.org/10.1056/NEJM200003233421202

Roca-Rodríguez, M., Garrido-Sánchez, L., García-Almeida, J., Ruiz-Nava, J., Alcaide-Torres, J., Gómez-González, A., Montiel-Trujillo, A., & Tinahones-Madueño, F. (2015). Effects of exercise on inflammation in cardiac rehabilitation. Nutricion Hospitalaria, 31(6), 2633-2640. https://doi.org/10.3305/nh.2015.31.6.8868

Ross, R. (1999). Atherosclerosis—An inflammatory disease. New England Journal Medicine, 2(320), 115-126. https://doi.org/10.1056/NEJM199901143400207

Sandor, B., Nagy, A., Toth, A., Rabai, M., Mezey, B., Csatho, A., Czuriga, I., Toth, K., & Szabados, E. (2014). Effects of moderate aerobic exercise training on hemorheological and laboratory parameters in ischemic heart disease patients. PloS One, 9(10), e110751. https://doi.org/10.1371/journal.pone.0110751

Shin, Y.-O., Bae, J.-S., Lee, J.-B., Kim, J.-K., Kim, Y.-J., Kim, C., Ahn, J.-K., Bang, I.-K., Lee, B.-K., Othman, T., Min, Y.-K., & Yang, H.-M. (2006). Effect of cardiac rehabilitation and statin treatment on anti-HSP antibody titers in patients with coronary artery disease after percutaneous coronary intervention. International Heart Journal, 47(5), 671-682. https://doi.org/10.1536/ihj.47.671

Starkie, R., Ostrowski, S., Jauffred, S., Febbraio, M., & Pedersen, B. (2003). Exercise and IL-6 infusion inhibit endotoxin-induced TNF-alpha production in humans. FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology, 17(8), 884-886. https://doi.org/10.1096/fj.02-0670fje

Stemme, S., Faber, B., Holm, J., Wiklund, O., Witztum, J., & Hansson, G. (1995). T lymphocytes from human atherosclerotic plaques recognize oxidized low density lipoprotein. Proceedings of the National Academy of Sciences of the United States of America, 92(9), 3893-3897. https://dx.doi.org/10.1073%2Fpnas.92.9.3893

Subiela, J., Torres, S., De Sanctis, J., & Hernández, N. (2018). Cardiorespiratory responses, nitric oxide production and inflammatory factors in patients with myocardial infarction after rehabilitation. Nitric Oxide: Biology and Chemistry, 76, 87-96. https://doi.org/10.1016/j.niox.2018.03.006

Swardfager, W., Herrmann, N., Cornish, S., Mazereeuw, G., Marzolini, S., Sham, L., & Lanctôt, K. L. (2012). Exercise intervention and inflammatory markers in coronary artery disease: A meta-analysis. American Heart Journal, 163(4), 666-676.e3. https://doi.org/10.1016/j.ahj.2011.12.017

Tabaei, S., Motallebnezhad, M., & Tabaee, S. S. (2020). Systematic review and meta-analysis of association of polymorphisms in inflammatory cytokine genes with coronary artery disease. Inflammation Research, 69(10), 1001-1013. https://doi.org/10.1007/s00011-020-01385-3

Taylor, R., Sagar, V., Davies, E., Briscoe, S., Coats, A. J. S., Dalal, H., Lough, F., Rees, K., & Singh, S. (2014). Exercise-based rehabilitation for heart failure. The Cochrane Database of Systematic Reviews, 4, CD003331. https://doi.org/10.1002/14651858.CD003331.pub4

Vanhees, L., Rauch, B., Piepoli, M., van Buuren, F., Takken, T., Börjesson, M., Bjarnason, B., Doherty, P., Dugmore, D., & Halle, M. (2012). Importance of characteristics and modalities of physical activity and exercise in the management of cardiovascular health in individuals with cardiovascular disease (Part III). European Journal of Preventive Cardiology, 19(6), 1333-1356. https://doi.org/10.1177/2047487312437063

Widlansky, M., Gokce, N., Keaney, J., & Vita, J. (2003). The clinical implications of endothelial dysfunction. Journal of the American College of Cardiology, 42(7), 1149-1160. https://doi.org/10.1016/s0735-1097(03)00994-x

Yancy, C., Jessup, M., Bozkurt, B., Butler, J., Casey, D., Colvin, M., Drazner, M., Filippatos, G., Fonarow, G., Givertz, M., Hollenberg, S., Lindenfeld, J., Masoudi, F., McBride, P., Peterson, P., Stevenson, L., & Westlake, C. (2017). 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Journal of Cardiac Failure, 23(8), 628-651. https://doi.org/10.1016/j.cardfail.2017.04.014

Published
2021-12-09
How to Cite
Trejos-Montoya, J. (2021). Aerobic Versus Concurrent Exercise on Interleukin-6 in Patients with Coronary Arterial Disease: A Systematic Review. MHSalud: Revista En Ciencias Del Movimiento Humano Y Salud, 19(1), 1-12. https://doi.org/10.15359/mhs.19-1.5

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