The Influence of Exercise-Based Cardiac Rehabilitation on Biomarker Profiles in Coronary Heart Disease

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 ۲۰۰۰ to May ۲۰۲۴. 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 ۴۰ 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 ۳۲%), interleukin-۶, and tumour necrosis factor-alpha; improved lipid profiles (increase in HDL-C of ۵–۱۰%, reduction in triglycerides of ۱۵–۲۰%); better endothelial function (increase in Flow-Mediated Dilation of ۱.۵–۳.۰%); lower myocardial stress (NT-proBNP reduction of ۲۵–۴۰%); and enhanced insulin sensitivity (HOMA-IR reduction of ۱۵–۳۰%).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.

کلیدواژه ها:

Cardiac Rehabilitation ، Biomarker ، Coronary heart disease