| Exercise training in advanced heart failure patients: discordance between improved exercise tolerance and unchanged NT-proBNP levels. | |
| | |
MedLine Citation:
|
PMID: 17651845 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Exercise training can improve aerobic capacity and symptoms in congestive heart failure (CHF) patients. AIMS: To test the feasibility of exercise training in advanced CHF patients, and examine the potential benefit from peripheral vascular and muscular conditioning as well as improved central hemodynamic and neurohumoral status. METHODS AND RESULTS: Thirty NYHA functional class III, CHF patients (mean age 61+/-13 yr, ejection fraction 27+/-4%, VO2max 11.3+/-3.9 ml/kg/min) were enrolled. Exercise capacity, cardiovascular parameters and serum levels of brain natriuretic peptide (NT-proBNP) were determined at baseline and after 18 weeks of moderate intensity exercise training. Twenty eight (93%) patients, who completed the exercise program, experienced marked improvements in the 6 min walk (+39%) and exercise duration on the modified Bruce protocol (+66%). Smaller improvements were recorded in the cardiac index (a 15% increase), in the maximal oxygen consumption (a 13% increase in VO2max), in the left ventricular ejection fraction (an 11% increase) and in the systemic vascular resistance and pulmonary artery pressure (an 11% decrease). NT-proBNP levels were not significantly affected. They correlated with exercise capacity and VO2max on baseline measurement, but these correlations were not found after training. CONCLUSION: Rehabilitation is feasible, even in advanced CHF, and leads to markedly improved exercise performance, but does not affect the level of the principal neurohumoral marker of prognosis - NT-proBNP. Resting cardiovascular performance and maximal oxygen consumption improve less than functional capacity, suggesting that an important benefit is derived from muscle conditioning and improved peripheral vascular response to exercise. |
| | |
Authors:
|
Michael Arad; Yehuda Adler; Nira Koren-Morag; Shy Natanzon; Ben-Ami Sela; Issahar Ben Dov; Michael Shechter; Ehud Schwammenthal; Dov Freimark |
Related Documents
:
|
12943875 - Effects of cold exposure on submaximal exercise performance and adrenergic activation i... 15809365 - Antioxidative effects of exercise training in patients with chronic heart failure: incr... 20657715 - Cardiopulmonary exercise testing in patients with chronic heart failure: prognostic com... 18515805 - Combined endurance-resistance training vs. endurance training in patients with chronic ... 9424065 - Accuracy and cost-effectiveness of exercise echocardiography for detection of coronary ... 17272095 - A new ecg obtained from mcg-recordings. |
Publication Detail:
|
Type: Comparative Study; Journal Article Date: 2007-07-24 |
Journal Detail:
|
Title: International journal of cardiology Volume: 126 ISSN: 1874-1754 ISO Abbreviation: Int. J. Cardiol. Publication Date: 2008 May |
Date Detail:
|
Created Date: 2008-04-21 Completed Date: 2008-09-15 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8200291 Medline TA: Int J Cardiol Country: Netherlands |
Other Details:
|
Languages: eng Pagination: 114-9 Citation Subset: IM |
Affiliation:
|
Heart Failure Service and Heart Institute, Sheba Medical Center, Tel Hashomer, Israel. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Aged, 80 and over Exercise / physiology* Exercise Test / methods Exercise Tolerance / physiology* Female Heart Failure / blood*, physiopathology* Humans Male Middle Aged Natriuretic Peptide, Brain / blood* Peptide Fragments / blood* Ventricular Dysfunction, Left / blood, physiopathology |
| Chemical | |
Reg. No./Substance:
|
0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Late ventricular remodeling in non-reperfused acute myocardial infarction in humans is predicted by ...
Next Document: Predictive values of the electrocardiogram in diagnosing pulmonary hypertension.