***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND / AIM Inflammation is an important factor in the pathogenesis of atherosclerosis , and several markers of inflammation have been associated with an increased risk of cardiovascular events . Physical activity may lower the risk for coronary heart disease ( CHD ) by mitigating inflammation . The aim of this study was to investigate the effects of aerobic physical exercise on systemic inflammatory response in patients with stable coronary disease participating in a cardiovascular rehabilitation exercise program .  METHODS Male ( n=29 ) and female ( n=23 ) patients with stable coronary heart disease were enrolled in this study . All the patients were divided into two groups : the group with regular aerobic physical training during cardiovascular rehabilitation program phase II for 3 weeks in our rehabilitation center and 3 weeks after that in their home setting , and sedentary lifestyle group . There were no significant differences in gender distribution among the analysed groups . Student 's t-test showed no significant differences in average age , waist circumference ( OS ) and waist/hip ratio ( WHR ) . RESULTS The degree of obesity was measured by BMI and there was a significant improvement in BMI in the patients who undertook 6-week physical training compared to the controls ( p<0.05 ) . Physical training during 6-week appeared not to have any effects on leukocite count and ICAM-1 levels compared to controls . Exercise induced reduction in plasma CRP levels by 23.72 % ( p<0.001 ) and reduction in plasma VCAM-1 levels by 10.23 % , ( p<0.05 ) . CONCLUSION Moderate aerobic exercise result ed in a significant reduction of inflammatory state by decreasing CRP and VCAM-1 levels with significant obesity reduction but without visceral obesity reduction . The obtained results indicate that regular physical activity is clinical ly desirable in primary and secondary prevention of coronary heart disases OBJECTIVES The aim of this study was to assess the effects of regular physical exercise on local inflammatory parameters in the skeletal muscle of patients with chronic heart failure ( CHF ) . BACKGROUND Inflammatory activation with increased serum cytokine levels and expression of inducible nitric oxide synthase ( iNOS ) in the myocardium and peripheral skeletal muscles has been described in CHF . METHODS Twenty male patients with stable CHF ( left ventricular ejection fraction 25 + /- 2 % ; age 54 + /- 2 years ) were r and omized to a training group ( n = 10 ) or a control group ( n = 10 ) . At baseline and after six months , serum sample s and vastus lateralis muscle biopsies were obtained . Serum tumor necrosis factor (TNF)-alpha , interleukin (IL)-6 , and IL-1-beta levels were measured by enzyme-linked immunosorbent assay , local cytokine , and iNOS expression by real-time polymerase chain reaction . RESULTS Exercise training improved peak oxygen uptake by 29 % in the training group ( from 20.3 + /- 1.0 to 26.1 + /- 1.5 ml/kg . min ; p < 0.001 vs. control group ) . While serum levels of TNF-alpha , IL-6 , and IL-1-beta remained unaffected by training , local skeletal muscle TNF-alpha decreased from 1.9 + /- 0.4 to 1.2 + /- 0.3 relative U ( p < 0.05 for change vs. control group ) , IL-6 from 71.3 + /- 16.5 to 41.3 + /- 8.8 relative U ( p < 0.05 vs. begin ) , and IL-1-beta from 2.7 + /- 1.1 to 1.4 + /- 0.6 relative U ( p = 0.02 vs. control group ) . Exercise training also reduced local iNOS expression by 52 % ( from 6.3 + /- 1.2 to 3.0 + /- 1.0 relative U ; p = 0.007 vs. control group ) . CONCLUSIONS Exercise training significantly reduced the local expression of TNF-alpha , IL-1-beta , IL-6 , and iNOS in the skeletal muscle of CHF patients . These local anti-inflammatory effects of exercise may attenuate the catabolic wasting process associated with the progression of CHF Objective To observe the prognostic influences of the cardiac rehabilitation ( CR ) program in Korean acute myocardial infa rct ion ( AMI ) patients during the first year after an occurrence of the disease . Method A total of 141 AMI patients who underwent percutaneous coronary intervention ( PCI )  were recruited consecutively for this study and divided into the CR group and the control group . The CR group completed the phase 2 CR program in the hospital for a period of 6 - 8 weeks and maintained self-exercise in their community by exercise prescription for a year after AMI . We performed a prospect i ve comparison of the patients ' demographic data , high sensitive C-reactive protein ( hs-CRP ) level after the 4-month CR program , and the rate of recurrence ( AMI , re-hospitalization , positive coronary angiogram , needed revascularization procedure , or death ) between the two groups . Results Compared to the control group ( 0.33±0.48 mg/dl ) , the hs-CRP level was lower in the CR group ( 0.18±0.32 mg/dl ) after 4 months of exercise . The recurrence rate was lower ( 10 % , 7/69 ) in the CR group , compared to the control group ( 24 % , 17/72 , p<0.05 ) . The number of disease-free days was larger in the CR group ( 354±38.34 ) , compared to the control group ( 316±99.96 , p<0.05 ) . In a comparison of statistical methods used for testing the e quality of two survivor distributions , the CR group showed a lower recurrence rate than the control group ( p<0.05 ) . Conclusion Participation in the CR program design ed for AMI patients who underwent PCI-induced normalization of the serum hs-CRP level and lowering of the recurrence rate by 14 % during the first year Background In cardiac rehabilitation , 40 - 60-min exercise training sessions are advised . However , because of the increasing coronary artery disease ( CAD ) prevalence and higher workload for cardiac rehabilitation centres , it remains unclear whether 40-min exercise training sessions are equally effective as 60-min exercise training sessions . Design Prospect i ve r and omized clinical trial . Methods One hundred and thirty-four CAD patients were included in a 7-week rehabilitation programme . All patients exercised 3 days per week , at a heart rate corresponding to 65 % of baseline peak oxygen uptake ( VO2peak ) . Patients were r and omized in two groups : 40 versus 60-min exercise training sessions .  Changes of body anthropometrics , resting haemodynamics , exercise capacity and ventilatory threshold , blood plasma lipid profile and C-reactive protein level were assessed . Results As a result of rehabilitation , exercise capacity , ventilatory threshold , and blood plasma lipid profile improved significantly in the total population ( P < 0.05 ) , without differences between subgroups ( P > 0.05 ) . Body weight and waist circumference decreased significantly in total population ( P < 0.01 ) , but with a greater magnitude in the 40 versus 60-min exercise session group ( P < 0.05 ) . Conclusions In the early rehabilitation of CAD patients , 40-min exercise training sessions seem to be at least as effective for improving body anthropometrics , blood plasma lipid profile and exercise capacity , as compared with 60-min exercise training sessions . Eur J Cardiovasc Prev Rehabil 15:453 - 459 © 2008 The European Society of Cardiology The aim of this investigation was to determine the effect of exercise training on the levels of plasma cytokines and acute phase reactants in the early post acute myocardial infa rct ion ( AMI ) period . Sixty patients were enrolled into this three-week cardiac rehabilitation study . The mean time from AMI was 7.08 + /- 1.60 days , and the patient mean age was 60 + /- 10 years . Subjects were r and omly assigned to one of the two groups : the control group treated with st and ard measures , and the group with additional regular moderate-intensity exercise training . Physical activity was based on the ergospirometry test results . Apart from clinical follow-up and routine laboratory analysis we determined the levels of plasma cytokines : tumor necrosis factor ( TNF-alpha ) , soluble TNF-alpha receptor 1 ( TNF-alphaSR1 ) , interleukin (IL)-8 , IL-10 , and acute phase reactants : high sensitivity C-reactive protein ( hsCRP ) and fibrinogen . The obtained results confirmed the hypothesis that the early post AMI period is an inflammatory state the intensity of which gradually decreases with st and ard treatment during the first month after AMI , while including patients into early exercise training improves their inflammatory profile by decreasing the level of acute phase reactant and TNF-alphaSR1 Dear Editor , Atherosclerotic cardiovascular diseases are the major cause of death in middle-aged and older-adults.[1][2 ] Today , inflammation is regarded as the key pathogenic mechanism in both initiation and progression of atherosclerosis.[3]Inflammatory markers such as high sensitive C-reactive protein ( CRP ) have been used to identify patients at higher risk for coronary events . The prognostic value of CRP has been established for patients with acute coronary syndrome , stable coronary artery diseases[4 ] and in apparently healthy people.[5][6 ] Comprehensive cardiac rehabilitation is probably the most effective approach for cardiovascular reduction and long-term care of cardiac patients as well as subjects with multiple coronary risk factors.[7][8 ] Secondary prevention , through cardiac rehabilitation program is now regarded as an essential component of contemporary management of patients with various presentations of coronary disease.[9 ] There are some evidence s that protective effects of cardiac rehabilitation may in part be related to lowering of inflammation . The goal of this prospect i ve study was to assess the effect of cardiac rehabilitation on high sensitive CRP as a marker of increased risk of coronary artery disease . The subjects were r and omly selected from patients with recent anterior wall myocardial infa rct ion referring to Alzahra Cardiac Rehabilitation Center in Shiraz from May to December 2007 . Inclusion criteria were males and females aged 30 - 75 years with anterior wall MI in past 1 month . Patients were divided into two groups . Group A consisted of 30 participants who received cardiac rehabilitation  and group B consisting of 26 participants which did not receive any cardiac rehabilitation program .  CRP levels were assessed before starting the program and eight weeks later . We used CRP Quantitative Diagnostic Kit for serum and plasma-Photometry technique . The data were analyzed by Wilcoxon Signed Rank and Mann-Whitney tests . The cardiac rehabilitation program included 8 weeks of exercise training , education and behavior modification therapy 3 times per week . The exercise training included arm and leg ergometry and treadmills . Behavioral modifications were smoking cessation , healthy nutrition , hypertension control , etc . The average age of patients was 62.7 years old . At enrollment , 66 % ( n=20 ) of participants in cardiac rehabilitation ( group A ) had CRP levels in the intermediate and high-risk range of > 1 mg/dl and after completion of cardiac rehabilitation only 27 % ( n= 5 ) of patients had elevated CRP levels ( P=0.0009 ) . In the group B , 73 % ( n=19 ) of participants had CRP levels > 1 mg/dl and after eight weeks , 53 % ( n=14 ) of them had CRP levels > 1 mg/dl ( p=0.50 ) . A higher CRP level was observed in patients 65 years , but both age groups demonstrated significant improvements in CRP postcardiac rehabilitation . This study showed a significant decrease in CRP levels in patients with cardiac disease after participation in cardiac rehabilitation program .  The findings showed that cardiac rehabilitation decreased vascular inflammation accompanying improvement in risk factors . Regardless of gender , there was a significant decrease in CPR at the completion of cardiac rehabilitation . The decrease in inflammation along with previously described benefits of cardiac rehabilitation supports the recommendations of American Heart Association and American Association of Cardiovascular and Pulmonary Rehabilitation that participation in cardiac rehabilitation should be a part of comprehensive care of cardiac patients . The findings in our study had two important clinical implication s. First , the potential independent effect of cardiac rehabilitation in lowering CRP levels was demonstrated which is independent from weight in our study . The non-pharmacologic mechanism for this observation may be due to dietary modifications , weight management and exercise components of the program . Secondly , the decrease in vascular inflammation associated with cardiac rehabilitation is evident regardless of gender , age and metabolic syndrome INTRODUCTION Accurate estimates of the incidence of cardiovascular diseases ( CVD ) comprising of acute myocardial infa rct ion ( AMI ) , unstable angina pectoris ( UAP ) , sudden cardiac death ( SCD ) , and stroke are very important for public health . However , such information is scarce , especially for middle- and low-income countries . METHODS The Isfahan Cohort Study ( ICS ) prospect ively followed up 6504 individuals , 51.8 % women , aged 35 years and over , 6323 initially free of 
    Output:
    
Both short- and long-term CR have result ed in improvement in serum hs-CRP levels .
CR can be perceived as a beneficial tool to reduce inflammatory markers among patients with previous cardiac events