| Controlled trial of physical training in chronic heart failure. Exercise performance, hemodynamics, ventilation, and autonomic function. | |
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MedLine Citation:
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PMID: 1591831 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Many secondary abnormalities in chronic heart failure (CHF) may reflect physical deconditioning. There has been no prospective, controlled study of the effects of physical training on hemodynamics and autonomic function in CHF. METHODS AND RESULTS: In a controlled crossover trial of 8 weeks of exercise training, 17 men with stable moderate to severe CHF (age, 61.8 +/- 1.5 years; left ventricular ejection fraction, 19.6 +/- 2.3%), increased exercise tolerance (13.9 +/- 1.0 to 16.5 +/- 1.0 minutes, p less than 0.001), and peak oxygen uptake (13.2 +/- 0.9 to 15.6 +/- 1.0 ml/kg/min, p less than 0.01) significantly compared with controls. Training increased cardiac output at submaximal (5.9-6.7 l/min, p less than 0.05) and peak exercise (6.3-7.1 l/min, p less than 0.05), with a significant reduction in systemic vascular resistance. Training reduced minute ventilation and the slope relating minute ventilation to carbon dioxide production (-10.5%, p less than 0.05). Sympathovagal balance was altered by physical training when assessed by three methods: 1) RR variability (+19.2%, p less than 0.05); 2) autoregressive power spectral analysis of the resting ECG divided into low-frequency (-21.2%, p less than 0.01) and high-frequency (+51.3%, p less than 0.05) components; and 3) whole-body radiolabeled norepinephrine spillover (-16%, p less than 0.05). These measurements all showed a significant shift away from sympathetic toward enhanced vagal activity after training. CONCLUSIONS: Carefully selected patients with moderate to severe CHF can achieve significant, worthwhile improvements with exercise training. Physical deconditioning may be partly responsible for some of the associated abnormalities and exercise limitation of CHF, including abnormalities in autonomic balance. |
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Authors:
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A J Coats; S Adamopoulos; A Radaelli; A McCance; T E Meyer; L Bernardi; P L Solda; P Davey; O Ormerod; C Forfar |
Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Circulation Volume: 85 ISSN: 0009-7322 ISO Abbreviation: Circulation Publication Date: 1992 Jun |
Date Detail:
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Created Date: 1992-06-26 Completed Date: 1992-06-26 Revised Date: 2010-03-24 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 2119-31 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiac Medicine, National Heart and Lung Institute, London, UK. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Autonomic Nervous System
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physiology Electrocardiography / methods Exercise Test Exercise Therapy* Heart Failure / physiopathology, rehabilitation* Hemodynamics / physiology Humans Male Middle Aged Norepinephrine / blood Pulmonary Gas Exchange / physiology Signal Processing, Computer-Assisted |
| Chemical | |
Reg. No./Substance:
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51-41-2/Norepinephrine |
| Comments/Corrections | |
Comment In:
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Circulation. 1992 Jun;85(6):2323-5
[PMID:
1591849
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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