Document Detail


Maximizing patient benefit from cardiac resynchronization therapy with the addition of structured exercise training: a randomized controlled study.
MedLine Citation:
PMID:  19539142     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We evaluated the benefits of additional exercise training after cardiac resynchronization therapy (CRT). BACKGROUND: Cardiac resynchronization therapy results in improved morbidity and mortality in appropriate patients. We hypothesized that a structured exercise training program in addition to CRT would maximize the improvements in exercise capacity, symptoms, and quality of life (QOL). METHODS: Fifty patients referred for CRT were recruited. Patients were assessed before and 3 and 6 months after CRT. Functional class and QOL scores were recorded, and exercise tests were performed with hemodynamic measurements. Peak lower limb skeletal muscle torque was measured during extension, and echocardiography was undertaken at each visit. At 3 months, patients were randomized with a simple sealed envelope method to exercise training (n = 25) or control group (n = 25). The exercise group underwent an exercise program consisting of 3 visits/week for 3 months. Paired sample t tests were used to look for in-group differences and independent sample t tests for between-group differences. RESULTS: Three months after CRT there were significant improvements in all functional, exercise hemodynamic, and echocardiographic measures. After randomization the exercise group showed further significant improvements in functional, exercise hemodynamic, and QOL measures compared with the control group. There were also significant in-group improvements in peak skeletal muscle function and ejection fraction that did not reach statistical significance on intergroup analysis. CONCLUSIONS: Exercise training leads to further improvements in exercise capacity, hemodynamic measures, and QOL in addition to the improvements seen after CRT. Therefore, exercise training allows maximal benefit to be attained after CRT.
Authors:
Ashish Y Patwala; Paul R Woods; Lisa Sharp; David F Goldspink; Lip B Tan; David J Wright
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  53     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-22     Completed Date:  2009-07-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2332-9     Citation Subset:  AIM; IM    
Affiliation:
Liverpool Heart and Chest Hospital, Liverpool, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Cardiac Pacing, Artificial*
Echocardiography
Exercise Therapy*
Female
Follow-Up Studies
Heart Failure / rehabilitation*
Humans
Male
Middle Aged
Muscle, Skeletal / physiology*
Oxygen Consumption*
Pacemaker, Artificial
Quality of Life
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2009 Jun 23;53(25):2340-2   [PMID:  19539143 ]

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


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