Document Detail


10-year exercise training in chronic heart failure: a randomized controlled trial.
MedLine Citation:
PMID:  22999730     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study investigated the effect of a very long-term exercise training program is not known in chronic heart failure (CHF) patients.
BACKGROUND: We previously showed that long-term moderate exercise training (ET) improves functional capacity and quality of life in New York Heart Association class II and III CHF patients.
METHODS: We studied 123 patients with CHF whose condition was stable over the previous 3 months. After randomization, a trained group (T group, n = 63) underwent a supervised ET at 60% of peak oxygen consumption (Vo(2)), 2 times weekly for 10 years, whereas a nontrained group (NT group, n = 60) did not exercise formally. The ET program was supervised and performed mostly at a coronary club with periodic control sessions twice yearly at the hospital's gym.
RESULTS: In the T group, peak Vo(2) was more than 60% of age- and gender-predicted maximum Vo(2) each year during the 10-year study (p < 0.05 vs. the NT group). In NT patients, peak Vo(2) decreased progressively with an average of 52 ± 8% of maximum Vo(2) predicted. Ventilation relative to carbon dioxide output (VE/Vco(2)) slope was significantly lower (35 ± 9) in T patients versus NT patients (42 ± 11, p < 0.01). Quality-of-life score was significantly better in the T group versus the NT group (43 ± 12 vs. 58 ± 14, p < 0.05). During the 10-year study, T patients had a significant lower rate of hospital readmission (hazard ratio: 0.64, p < 0.001) and cardiac mortality (hazard ratio: 0.68, p < 0.001) than controls. Multivariate analysis selected peak Vo(2) and resting heart rate as independent predictors of events.
CONCLUSIONS: Moderate supervised ET performed twice weekly for 10 years maintains functional capacity of more than 60% of maximum Vo(2) and confers a sustained improvement in quality of life compared with NT patients. These sustained improvements are associated with reduction in major cardiovascular events, including hospitalizations for CHF and cardiac mortality.
Authors:
Romualdo Belardinelli; Demetrios Georgiou; Giovanni Cianci; Augusto Purcaro
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2012-09-19
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  60     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-12     Completed Date:  2012-12-28     Revised Date:  2013-03-29    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1521-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiovascular Sciences, Sections of Cardiac Rehabilitation and Prevention, Lancisi Heart Institute, Ancona, Italy. r.belardinelli@ospedaliriuniti.marche.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Chronic Disease / therapy
Exercise*
Exercise Therapy*
Exercise Tolerance
Female
Heart Failure / therapy*
Humans
Male
Middle Aged
Oxygen Consumption
Quality of Life
Stroke Volume
Treatment Outcome
Comments/Corrections
Comment In:
J Physiother. 2013 Mar;59(1):56   [PMID:  23419918 ]
Ann Intern Med. 2013 Feb 19;158(4):JC6   [PMID:  23420254 ]
J Am Coll Cardiol. 2012 Oct 16;60(16):1529-30   [PMID:  22999726 ]

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