Translational Health Reports

Abstract Background: Coronary Heart Disease (CHD) is a widespread health challenge characterized by intricate pathophysiological mechanisms such as chronic inflammation, endothelial impairment, and metabolic irregularities. Exercise-focused Cardiac Rehabilitation (CR) is a key element of secondary prevention, known to decrease mortality and improve health outcomes. Examining its impact on a diverse range of biomarkers offers deeper insight into the biological mechanisms behind these benefits.
Objective: This systematic review consolidates current research on the effects of structured exercise training within CR on biomarkers related to critical pathological areas in CHD patients, including inflammation, lipid metabolism, vascular function, myocardial stress, and metabolic health.
Methods: A systematic search of PubMed, Scopus, and the Cochrane Central Register of Controlled Trials was conducted from January 2000 to May 2024. Randomized controlled trials, meta-analyses, and prospective cohort studies evaluating the impact of exercise-based CR on biomarkers in adults with confirmed CHD were included.
Results: Analysis of 40 high-quality studies shows that exercise-based CR consistently produces beneficial changes across multiple biomarker pathways. Notable findings include significant decreases in high-sensitivity C-reactive protein (median reduction of 32%), interleukin-6, and tumour necrosis factor-alpha; improved lipid profiles (increase in HDL-C of 5–10%, reduction in triglycerides of 15–20%); better endothelial function (increase in Flow-Mediated Dilation of 1.5–3.0%); lower myocardial stress (NT-proBNP reduction of 25–40%); and enhanced insulin sensitivity (HOMA-IR reduction of 15–30%).
Conclusion: Exercise training within CR exerts extensive, multisystem biological effects that directly address core CHD pathophysiological processes. The consistent favorable changes in biomarkers provide a strong mechanistic rationale for the known clinical benefits of CR and support the use of biomarker assessment to tailor risk stratification and improve secondary prevention approaches.

Abstract Background: Physical inactivity is a key risk factor for coronary heart disease (CHD). This systematic review explores the role of exercise in cardiac rehabilitation for CHD patients, emphasizing the integration of nuclear stress tests and tumor imaging techniques to assess heart function.

Materials and Methods: A systematic review was conducted, analyzing randomized controlled trials (RCTs) indexed in the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and EMBASE. Studies were selected based on criteria related to exercise-based cardiac rehabilitation, including outcomes such as cardiovascular mortality, hospitalization, and quality of life. Imaging methods, such as nuclear stress tests and tumor imaging, were also considered. The quality of the studies was assessed using the Cochrane Risk of Bias tool.

Results: Five RCTs were included in the final analysis. The reviewed literature consistently reported that exercise-based cardiac rehabilitation led to reductions in cardiovascular mortality and hospital admissions, alongside notable improvements in patient quality of life. The inclusion of nuclear stress tests was found to improve diagnostic accuracy for identifying myocardial ischemia and assessing heart function during exercise. Tumor imaging techniques were successfully used to identify cardiac tumors and monitor post-surgical heart function.

Conclusion: This systematic review supports the integration of exercise as a core component of cardiac rehabilitation programs for CHD patients. The findings indicate significant benefits in reducing cardiovascular mortality and improving quality of life. The use of nuclear stress tests and tumor imaging techniques enhances the precision of rehabilitation strategies, offering a more personalized approach to care.