Evidence map›Paper›PMID 24439980›Full record

Trial reportAmerican heart journal2014

The effects of exercise on cardiovascular biomarkers in patients with chronic heart failure.

Tariq Ahmad, Mona Fiuzat, Daniel B Mark, Ben Neely, Megan Neely, William E Kraus, Dalane W Kitzman, David J Whellan, Mark Donahue, Faiez Zannad and 4 more

Open access · greenAbstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in American heart journal, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 3 pooled it
2.8field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 3 syntheses or guidelines pooled it, 62 citations in OpenAlex.

  1. Exercise-based cardiac rehabilitation for adults with heart failure.The Cochrane database of systematic reviews · 2019
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  14. Monitoring the Effects of Cardiac Rehabilitation Programs in Heart Failure Patients: The Role of Biomarkers.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2025
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  20. Effects of a home based exercise intervention on cardiac biomarkers, liver enzymes, and cardiometabolic outcomes in CABG and PCI patients.Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 7 institutions in 3 countries.

Tariq AhmadDivision of Cardiology, Duke University Medical Center, Durham, NC; Duke Clinical Research Institute, Durham, NC.
Mona FiuzatDivision of Cardiology, Duke University Medical Center, Durham, NC; Duke Clinical Research Institute, Durham, NC.
Daniel B MarkDivision of Cardiology, Duke University Medical Center, Durham, NC; Duke Clinical Research Institute, Durham, NC.
Ben NeelyDuke Clinical Research Institute, Durham, NC.
Megan NeelyDuke Clinical Research Institute, Durham, NC.
William E KrausDivision of Cardiology, Duke University Medical Center, Durham, NC.
Dalane W KitzmanWake Forest University, Winston-Salem, NC.
David J WhellanThomas Jefferson University, Philadelphia, PA.
Mark DonahueDivision of Cardiology, Duke University Medical Center, Durham, NC.
Faiez ZannadNancy University, Nancy, France.
Ileana L PiñaMontefiore Medical Center, Bronx, NY.
Kirkwood AdamsUniversity of North Carolina, Chapel Hill, NC.
Christopher M O'ConnorDivision of Cardiology, Duke University Medical Center, Durham, NC; Duke Clinical Research Institute, Durham, NC.
G Michael FelkerDivision of Cardiology, Duke University Medical Center, Durham, NC; Duke Clinical Research Institute, Durham, NC. Electronic address: michael.felker@duke.edu.
Duke Medical Center · USClinical Research Institute · USCentre Hospitalier Régional et Universitaire de Nancy · FRMontefiore Medical Center · USThomas Jefferson University · USUniversity of North Carolina at Chapel Hill · USWake Forest University · US

Funding

ACTION - A CHF Trial Investigating Outcomes of ExerciseU01HL063747 · NHLBI · DUKE UNIVERSITY · PI O'CONNOR, CHRISTOPHER M · 2002 to 2008
$24.8M
Postdoctoral Training in Cardiovascular Clinical ResearchT32HL069749 · NHLBI · DUKE UNIVERSITY · PI MARK, DANIEL B · 2003 to 2023
$6.7M
NHLBI NIH HHS T32 HL069749NHLBI NIH HHS U01 HL063747
6 · The paper itself

Abstract

backgroundExercise training is recommended for chronic heart failure (HF) patients to improve functional status and reduce risk of adverse outcomes. Elevated plasma levels of amino-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hs-CRP), and cardiac troponin T (cTnT) are associated with increased risk of adverse outcomes in this patient population. Whether exercise training leads to improvements in biomarkers and how such improvements relate to clinical outcomes are unclear. METHODS AND

resultsAmino-terminal pro-brain natriuretic peptide, hs-CRP, and cTnT levels were assessed at baseline and 3 months in a cohort of 928 subjects from the HF-ACTION study, a randomized clinical trial of exercise training versus usual care in chronic HF patients with reduced left ventricular ejection fraction (<35%). Linear and logistic regressions were used to assess 3-month biomarker levels as a function of baseline value, treatment assignment (exercise training vs usual care), and volume of exercise. Linear regression and Cox proportional hazard modeling were used to evaluate the relations between changes in biomarker levels and clinical outcomes of interest that included change in peak oxygen consumption (peak VO2), hospitalizations, and mortality. Exercise training was not associated with significant changes in levels of NT-proBNP (P = .10), hs-CRP (P = .80), or detectable cTnT levels (P = .83) at 3 months. Controlling for baseline biomarker levels or volume of exercise did not alter these findings. Decreases in plasma concentrations of NT-proBNP, but not hs-CRP or cTnT, were associated with increases in peak VO2 (P < .001) at 3 months and decreased risk of hospitalizations or mortality (P ≤ .04), even after adjustment for a comprehensive set of known predictors.

conclusionsExercise training did not lead to meaningful changes in biomarkers of myocardial stress, inflammation, or necrosis in patients with chronic HF. Only improvements in NT-proBNP translated to reductions in peak VO2 and reduced risk of clinical events.

Indexed as

BiomarkersC-Reactive ProteinDisease ProgressionExerciseExercise TestExercise TherapyFemaleFollow-Up StudiesHeart FailureHumansMaleMiddle AgedNatriuretic Peptide, BrainPeptide FragmentsStroke VolumeTreatment OutcomeBiomarkersC-Reactive ProteinNatriuretic Peptide, BrainPeptide Fragmentspro-brain natriuretic peptide (1-76)Troponin T

Identifiers

PMID24439980
PMCPMC3899586
OpenAlexW1989309700

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.