Angiopoietin-like protein 2 (ANGPTL2) promotes chronic
inflammation and plays a key role in the pathogenesis of
heart failure.
Cardiac rehabilitation (CR) is an integral component of
heart failure management and has been shown to have anti-inflammatory effects. However, ANGPTL2 concentration in chronic
heart failure patients undergoing CR has not been evaluated. This study aimed to investigate serum ANGPTL2 levels and their associated factors and compare the results with those of N-terminal pro-
brain natriuretic peptide (
NT-proBNP) in patients with chronic
heart failure undergoing phase III CR.A total of 56 patients were enrolled. Clinical characteristics including body composition, grip strength, exercise tolerance, duration of CR, blood counts and biochemistry, and echocardiographic parameters were evaluated for their association with serum ANGPTL2 and
NT-proBNP levels.The median (first and third quartiles) value of ANGPTL2 was 4.05 (2.70-5.57) ng/mL. Clinical parameters that correlated with serum ANGPTL2 levels were
body weight, body mass index, body fat mass, body fat percentage, anaerobic threshold (AT),
C-reactive protein, and total
protein (TP), which were mostly distinct from those that correlated with serum
NT-proBNP levels. A multivariate analysis revealed that AT and TP were independent factors related to ANGPTL2 levels, whereas age, left ventricular ejection fraction, and left atrial dimension were independently related to
NT-proBNP levels.These observations suggest that CR increases the exercise tolerance and exhibits anti-inflammatory effects simultaneously, and this situation is reflected by decreased serum ANGPLT2 and TP levels. ANGPTL2 may be a useful marker of
inflammation and impaired exercise tolerance in patients with chronic
heart failure.