Document Detail


Functional electrical stimulation is more effective in severe symptomatic heart failure patients and improves their adherence to rehabilitation programs.
MedLine Citation:
PMID:  20206900     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Functional electrical stimulation (FES) improves exercise capacity and quality of life in chronic heart failure (CHF) patients. However, there is no evidence regarding the effectiveness of this treatment modality according to the severity of CHF. This study compares the effectiveness of FES on exercise capacity, endothelial function, neurohormonal status, and emotional stress in New York Heart Association (NYHA) III-IV versus NYHA II patients. METHODS AND RESULTS: Eighteen NYHA II and 13 age- and sex-matched NYHA III-IV patients with stable CHF (left ventricular ejection fraction <35%) underwent a 6-week FES training program. Questionnaires addressing quality of life (Kansas City Cardiomyopathy Questionnaire, functional and overall), and emotional stress (Zung self-rating depression scale, Beck Depression Inventory), as well as plasma B-type natriuretic peptide (BNP), 6-minute walking distance test (6MWT), and endothelial function (flow-mediated dilatation [FMD]) were assessed at baseline and after completion of training protocol. 6MWT and plasma BNP improved significantly in 2 patient groups (both P < .001) after training program. The improvement of BNP was statistically greater in NYHA III-IV patients posttreatment than in those with NYHA II class (F=315.342, P < .001). Similarly, the improvement of 6MWT was statistically greater in NYHA III-IV group than in NYHA II patients (F=79.818, P < .001). Finally, an FES-induced greater improvement of FMD (F=9.517, P=.004) and emotional stress scores was observed in NYHA III-IV patients in comparison to NYHA II patients. There was a higher proportion of NYHA III-IV patients adhering to the FES training program for additional 3 months compared with the NYHA II group of patients (76.9% vs. 55.6%, P < .001). CONCLUSION: FES might exert a greater beneficial effect on clinical and neurohormonal status of NYHA III-IV patients in comparison to NYHA II patients. This effect may have important clinical relevance leading to increased adherence of severe CHF patients to exercise rehabilitation programs.
Authors:
Apostolos Karavidas; John T Parissis; Vassiliki Matzaraki; Sophia Arapi; Christos Varounis; Ignatios Ikonomidis; Panagiotis Grillias; Ioannis Paraskevaidis; Vlassios Pirgakis; Gerasimos Filippatos; Dimitios T Kremastinos
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-12-11
Journal Detail:
Title:  Journal of cardiac failure     Volume:  16     ISSN:  1532-8414     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-08     Completed Date:  2010-06-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  244-9     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 Elsevier Inc. All rights reserved.
Affiliation:
Cardiology Department, General Hospital G.Genimmatas, Athens, Greece.
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Electric Stimulation Therapy / methods*
Exercise Therapy / methods*
Exercise Tolerance / physiology*
Female
Follow-Up Studies
Heart Failure / classification,  rehabilitation*,  therapy
Heart Function Tests
Hemodynamics / physiology
Humans
Male
Middle Aged
Muscle Strength / physiology
Patient Compliance
Probability
Prospective Studies
Quality of Life*
Risk Factors
Severity of Illness Index
Stroke Volume
Treatment Outcome

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


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