{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T21:37:52Z","timestamp":1780695472965,"version":"3.54.1"},"reference-count":34,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Coronary heart disease (CHD) is a highly prevalent disease in the elderly population, with atherosclerosis as its pathology, which can also be viewed as a chronic inflammatory response of the organism. Regular moderate-intensity exercise can direct the immune response toward an anti-inflammatory state, which is beneficial for improving the health and exercise tolerance. In cardiac rehabilitation, attention to the management of inflammatory factors as well as the improvement of exercise endurance is beneficial for the rehabilitation of elderly patients with coronary artery disease. This study investigates the impact of tiered cardiac rehabilitation programs on levels of C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-\u03b1), and the capacity for physical exertion in older CHD patients. From March 2020 to April 2022, 94 elderly patients with CHD visiting our institution were recruited and randomly allocated into either a control group or an observation group, each comprising 47 participants. The standard care group participated in traditional rehabilitation exercises, whereas the experimental group received customized, tiered, cardiac rehabilitation interventions. We assessed the variations in CRP and tumor necrosis factor alpha (TNF-\u03b1) levels, along with exercise capacity, before and after treatment in both groups. The result shows that significant reductions in CRP and TNF-\u03b1 levels were seen in the experimental group after 4 and 12 weeks, compared to the standard care group. Analysis showed clear trends in CRP and TNF-\u03b1 changes over the interventions, with the experimental group showing better results. CRP levels decreased consistently, while TNF-\u03b1 levels stayed stable. The experimental group also showed improvements in physical endurance measures compared to the control group. Interleukin 6 (IL-6) and fibrinogen (Fib) in the observation group decreased compared with the control group (\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.01). After 12 weeks of treatment, CRP and TNF-\u03b1 showed significant negative correlation with exercise endurance index \u2013 6\u2009min walking test (6 MWT), anaerobic threshold (AT), maximum oxygen consumption (VO\n                    <jats:sub>2max<\/jats:sub>\n                    ), and exercise duration (ED); significant positive correlation between cardiac rehabilitation grade and exercise endurance index (6 MWT, AT, VO\n                    <jats:sub>2max<\/jats:sub>\n                    and ED); and both groups experienced cardiovascular adverse events and exercise muscle injury. The analysis shows that the graded nursing of cardiac rehabilitation can effectively reduce the levels of CRP, TNF-\u03b1, IL-6, and Fib in elderly patients with CHD and significantly improve the exercise endurance of patients with good safety.\n                  <\/jats:p>","DOI":"10.1515\/biol-2022-1040","type":"journal-article","created":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T15:58:12Z","timestamp":1747756692000},"source":"Crossref","is-referenced-by-count":2,"title":["Effects of tiered cardiac rehabilitation on CRP, TNF-\u03b1, and physical endurance in older adults with coronary heart disease"],"prefix":"10.1515","volume":"20","author":[{"given":"Cong","family":"Luo","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, The Fourth Hospital of Changsha , Changsha , 410219 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lan","family":"Li","sequence":"additional","affiliation":[{"name":"Ward of Neurology, The Fourth Hospital of Changsha , Changsha , 410006 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lan","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The Fourth Hospital of Changsha , Changsha , 410219 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengjiao","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The Fourth Hospital of Changsha , Changsha , 410219 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2025,5,20]]},"reference":[{"key":"2025122123392349269_j_biol-2022-1040_ref_001","doi-asserted-by":"crossref","unstructured":"Hossne NA, Jr, Dallan L, Lisboa L, Murad H, Gomes WJ. 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Validation of SCORE2 on a sample from the Russian population and adaptation for the very high cardiovascular disease risk region. PLoS One. 2024;19(4):e0300974.","DOI":"10.1371\/journal.pone.0300974"},{"key":"2025122123392349269_j_biol-2022-1040_ref_004","unstructured":"Luo C, Li L, Hou L, Shi F. 2020 PgftCCHaDR. Interpretation of report on cardiovascular health and diseases in China 2020. Chin J Cardiovasc Med. 2021;26(3):209\u201318."},{"key":"2025122123392349269_j_biol-2022-1040_ref_005","doi-asserted-by":"crossref","unstructured":"Kurl S, Jae SY, Voutilainen A, Laukkanen JA. The combined effect of blood pressure and C-reactive protein with the risk of mortality from coronary heart and cardiovascular diseases. Nutr Metab Cardiovasc Dis. 2021;31(7):2051\u20137.","DOI":"10.1016\/j.numecd.2021.04.004"},{"key":"2025122123392349269_j_biol-2022-1040_ref_006","doi-asserted-by":"crossref","unstructured":"Kourek C, Briasoulis A, Karatzanos E, Zouganeli V, Psarra K, Pratikaki M, et al. 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