Document Detail


Endurance exercise training in older patients with heart failure: results from a randomized, controlled, single-blind trial.
MedLine Citation:
PMID:  20121952     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To test the hypothesis that exercise training (ET) improves exercise capacity and other clinical outcomes in older persons with heart failure with reduced ejection fraction (HfrEF).
DESIGN: Randomized, controlled, single-blind trial.
SETTING: Outpatient cardiac rehabilitation program.
PARTICIPANTS: Fifty-nine patients aged 60 and older with HFrEF recruited from hospital records and referring physicians were randomly assigned to a 16-week supervised ET program (n=30) or an attention-control, nonexercise, usual care control group (n=29).
INTERVENTION: Sixteen-week supervised ET program of endurance exercise (walking and stationary cycling) three times per week for 30 to 40 minutes at moderate intensity regulated according to heart rate and perceived exertion.
MEASUREMENTS: Individuals blinded to group assignment assessed four domains pivotal to HFrEF pathophysiology: exercise performance, left ventricular (LV) function, neuroendocrine activation, and health-related quality of life (QOL).
RESULTS: At follow-up, the ET group had significantly greater exercise time and workload than the control group, but there were no significant differences between the groups for the primary outcomes: peak exercise oxygen consumption (VO(2) peak), ventilatory anaerobic threshold (VAT), 6-minute walk distance, QOL, LV volumes, EF, or diastolic filling. Other than serum aldosterone, there were no significant differences after ET in other neuroendocrine measurements. Despite a lack of a group "training" effect, a subset (26%) of individuals increased VO(2) peak by 10% or more and improved other clinical variables as well.
CONCLUSION: In older patients with HFrEF, ET failed to produce consistent benefits in any of the four pivotal domains of HF that were examined, although the heterogeneous response of older patients with HFrEF to ET requires further investigation to better determine which patients with HFrEF will respond favorably to ET.
Authors:
Peter H Brubaker; J Brian Moore; Kathryn P Stewart; Debra J Wesley; Dalane W Kitzman
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of the American Geriatrics Society     Volume:  57     ISSN:  1532-5415     ISO Abbreviation:  J Am Geriatr Soc     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2010-02-03     Completed Date:  2010-02-24     Revised Date:  2013-05-31    
Medline Journal Info:
Nlm Unique ID:  7503062     Medline TA:  J Am Geriatr Soc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1982-9     Citation Subset:  IM    
Affiliation:
Department of Health and Exercise Science, Wake Forest University, Wake Forest University, Winston-Salem, NC 27109, USA. brubaker@wfu.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Aldosterone / blood
Anaerobic Threshold / physiology
Angiotensin II / blood
Cardiac Output, Low / physiopathology,  rehabilitation
Cardiac Volume / physiology
Echocardiography
Exercise / physiology*
Female
Follow-Up Studies
Heart Failure / physiopathology,  psychology,  rehabilitation*
Humans
Male
Middle Aged
Oxygen / physiology
Physical Endurance / physiology*
Prospective Studies
Quality of Life / psychology
Single-Blind Method
Stroke Volume / physiology
Treatment Failure
Ventricular Dysfunction, Left / physiopathology,  psychology,  rehabilitation*
Ventricular Function, Left / physiology
Grant Support
ID/Acronym/Agency:
MO1RR07122/RR/NCRR NIH HHS; P30 AG021332-019001/AG/NIA NIH HHS; P30-AG21332/AG/NIA NIH HHS; R01 AG012257-07/AG/NIA NIH HHS; R01-AG12257/AG/NIA NIH HHS; R37 AG018915/AG/NIA NIH HHS; R37 AG018915-10/AG/NIA NIH HHS; R37-AG18915/AG/NIA NIH HHS
Chemical
Reg. No./Substance:
11128-99-7/Angiotensin II; 52-39-1/Aldosterone; 7782-44-7/Oxygen
Comments/Corrections
Comment In:
J Am Geriatr Soc. 2009 Nov;57(11):2148-50   [PMID:  20121958 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Biochemical evidence for conformational changes in the cross-talk between adenylation and peptidyl-c...
Next Document:  Empirical derivation and validation of a wandering typology.