Key result
Exercise training reduces IL-6, TNF-α, and CRP versus controls in patients with heart failure.
Why the study?
The study was conducted to identify the most effective exercise mode for reducing pro-inflammatory markers in patients with heart failure.
Does exercise training reduce pro-inflammatory markers in patients with heart failure?
Meta-Analysis (n=1,022)
Does exercise training reduce pro-inflammatory markers in patients with heart failure?
Standardized Mean Difference: -0.33 (95% CI -0.56–-0.11)
p-value: p=0.003
Exercise training, particularly resistance and combined training, effectively reduces chronic low-grade inflammation markers (IL-6, TNF-α, CRP) in patients with heart failure.
May refine exercise prescriptions to target inflammation in HF; extends comparative evidence across modalities with network meta-analysis.
Introduction/Purpose: The aim of this systematic review with pairwise and network meta-analyses was to identify the most effective exercise mode for reducing pro-inflammatory markers in patients with heart failure (HF). Methods: A systematic electronic search was carried out in PubMed, Scopus, and Web of Science from inception to June 2024 in English-language publications. Randomized trials investigating the effect of any mode of exercise training, including aerobic training (AT), resistance training (RT), combined training (CT), or Tai Chi/Yoga on pro-inflammatory markers, including IL-6, TNF-α, or CRP in patients with HF with reduced or preserved left ventricular ejection fraction (LVEF) were included. Standardized mean differences (SMDs) and 95% CIs were determined using random-effects models for meta-analyses. Results: A total of 21 studies involving 1,022 patients with HF were included. Overall, compared with controls (CON), exercise training was significantly more effective for reducing IL-6 (SMD -0.33, 95% CI -0.56 to -0.11, p=0.003), TNF-α (SMD -0.17, 95% CI -0.34 to -0.00, p=0.04), and CRP (SMD -0.57, 95% CI -1.02 to -0.13, p=0.01). Particularly, RT (SMD -0.91, 95% CI -1.32 to -0.49, p=0.001) and Tai Chi/Yoga (SMD -0.70, 95% CI -1.22 to -0.19, p=0.006) was the most effective modality for reducing IL-6, CT (SMD -0.44, 95%CI -0.80 to -0.09, p=0.01) and AT (SMD -0.25, 95% CI -0.49 to 0.01, p=0.03) was the optimal modality for lowering TNF-α, and CT (SMD -1.34, 95% CI -2.28 to -0.40, p=0.004) was the optimal modality for lowering CRP. Conclusions: Exercise training may contribute to improvements in chronic low-grade inflammation in patients with HF. RT is likely to be the most effective exercise mode for reducing IL-6, while of the exercise modalities studied, CT was optimal for lowering TNF-α and CRP. These findings should, however, be interpreted with caution due to heterogeneity and the limited number of studies.
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Khalafi et al. (2026) conducted a meta-analysis in Heart failure (n=1,022). Exercise training vs. Controls was evaluated on IL-6 (SMD -0.33, 95% CI -0.56 to -0.11, p=0.003). Exercise training significantly reduced IL-6 (SMD -0.33; 95% CI -0.56 to -0.11; p=0.003), TNF-α, and CRP compared with controls in patients with heart failure.
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