{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T10:24:29Z","timestamp":1784543069902,"version":"3.55.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":275,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T00:00:00Z","timestamp":1747612800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100017291","name":"Zhongshan Science and Technology Bureau","doi-asserted-by":"publisher","award":["no. 2021B1018"],"award-info":[{"award-number":["no. 2021B1018"]}],"id":[{"id":"10.13039\/501100017291","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Exercise training improves functional outcomes in chronic heart failure (HF), but the effects of early in-hospital physical activity on cardiovascular biomarkers and prognosis in acute congestive heart failure (AHF) patients remain unclear. This study investigated the short-term impact of early rehabilitation on prognostic biomarkers\u2014high-sensitivity troponin T (hs-TnT), N-terminal pro-B-type natriuretic peptide (NT-proBNP), soluble suppression of tumourigenesis-2 (sST2), galectin-3 (Gal-3) and endothelin-1 (ET-1)\u2014and evaluated associations with clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>A total of 118 hospitalized AHF patients (35 controls and 83 exercise group) underwent biomarker measurement before and after supervised rehabilitation using non-invasive cardiac output monitoring. Serum levels of NT-proBNP, hs-TnT, sST2, Gal-3, and ET-1 were analysed. Prognosis was assessed via 12-month follow-up for all-cause mortality. Statistical analysis included ANOVA for biomarker changes and Kaplan\u2013Meier survival analysis. Post-intervention, NT-proBNP levels increased significantly in the exercise group (2900 \u00b1 700 pg\/mL to 3500 \u00b1 760 pg\/mL, P = 0.012), as did ET-1 (1.9 \u00b1 0.4 pg\/mL to 2.4 \u00b1 0.5 pg\/mL, P = 0.018). Hs-TnT, sST2 and Gal-3 showed no significant changes (all P &amp;gt; 0.05). Survival analysis demonstrated higher baseline hs-TnT [hazard ratio (HR) 2.1, 95% confidence interval (CI) 1.3\u20133.4] and greater NT-proBNP elevation post-exercise (\u0394NT-proBNP HR 1.8, 95% CI 1.1\u20132.9) were independent predictors of mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Early in-hospital exercise in AHF patients transiently elevates NT-proBNP and ET-1, indicative of acute haemodynamic stress, without altering myocardial injury or fibrosis markers (hs-TnT, sST2 and Gal-3). Elevated baseline hs-TnT and post-exercise NT-proBNP increases correlate with poorer survival, highlighting their prognostic value in risk assessment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.15317","type":"journal-article","created":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T06:11:39Z","timestamp":1747721499000},"page":"2985-2992","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Effects of Early Exercise on Cardiovascular Biomarkers in Patients witH Congestive Heart Failure"],"prefix":"10.1093","volume":"12","author":[{"given":"Yanxiang","family":"Sun","sequence":"first","affiliation":[{"name":"Department of Cardiology, Zhongshan City People's Hospital , Zhongshan ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuansheng","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Zhongshan City People's Hospital 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