Comparison of the effects of two training modalities: home-based telemonitored walking training vs. cycle ergometer training on exercise capacity and inflammatory biomarkers in heart failure patients

Abstract Background The benefits of cardiac rehabilitation in heart failure (HF) patients are well established. Currently, we are focused on developing an optimal rehabilitation program that takes into account its duration, training modalities, and sites of implementation in order to achieve both improved physical capacity and reduced inflammation. Purpose The purpose of this study was to compare the effects of two training modalities: home-based telemonitored walking training vs. cycle ergometer training in an outpatient clinic - on exercise capacity and inflammatory biomarkers in HF patients. Methods The study enrolled 152 HF patients (mean age: 58.1 ± 10.2 years, NYHA II-III, LVEF ≤ 40%), who were randomized in a 1:1 ratio to either home-based telemonitored walking training (HTR) or cycle ergometer training in an outpatient clinic (OCR). All patients participated in these interventions for two months, five times per week. HTR was telemonitored using a device designed to record electrocardiograms (ECGs) and transmit data via a mobile phone network to the monitoring center. Both groups were comparable in terms of demographic and clinical characteristics as well as medical therapy. The effectiveness of both interventions was assessed by measuring changes in peak oxygen consumption (peak VO₂), workload duration (t) during the cardiopulmonary exercise test, and plasma concentrations of interleukin-6 (IL-6), tumor necrosis factor (TNF) α, and soluble TNF receptors (TNFR1 & TNFR2). Measurements were taken before and after the interventions. Results Both training modalities led to a significant improvement in peak VO₂ and workload duration. However, no favorable changes were observed in plasma concentrations of IL-6, TNF-α, or TNFR1 & TNFR2. The differences between the two groups were not statistically significant. All results are presented in Table 1. Conclusion Both home-based telemonitored walking training and cycle ergometer training in an outpatient clinic significantly improved physical capacity in HF patients. However, these interventions did not reduce inflammatory parameters. It is likely that a two-month rehabilitation program is too short to exert a beneficial effect on the inflammatory process in HF patients.