Document Detail


Relation between volume of exercise and clinical outcomes in patients with heart failure.
MedLine Citation:
PMID:  23062530     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study determined whether greater volumes of exercise were associated with greater reductions in clinical events.
BACKGROUND: The HF-ACTION (Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training) trial showed that among patients with heart failure (HF), regular exercise confers a modest reduction in the adjusted risk for all-cause mortality or hospitalization.
METHODS: Patients randomized to the exercise training arm of HF-ACTION who were event-free at 3 months after randomization were included (n = 959). Median follow-up was 28.2 months. Clinical endpoints were all-cause mortality or hospitalization and cardiovascular mortality or HF hospitalization.
RESULTS: A reverse J-shaped association was observed between exercise volume and adjusted clinical risk. On the basis of Cox regression, exercise volume was not a significant linear predictor but was a logarithmic predictor (p = 0.03) for all-cause mortality or hospitalization. For cardiovascular mortality or HF hospitalization, exercise volume was a significant (p = 0.001) linear and logarithmic predictor. Moderate exercise volumes of 3 to <5 metabolic equivalent (MET)-h and 5 to <7 MET-h per week were associated with reductions in subsequent risk that exceeded 30%. Exercise volume was positively associated with the change in peak oxygen uptake at 3 months (r = 0.10; p = 0.005).
CONCLUSIONS: In patients with chronic systolic HF, volume of exercise is associated with the risk for clinical events, with only moderate levels (3 to 7 MET-h per week) of exercise needed to observe a clinical benefit. Although further study is warranted to confirm the relationship between volume of exercise completed and clinical events, our findings support the use of regular exercise in the management of these patients.
Authors:
Steven J Keteyian; Eric S Leifer; Nancy Houston-Miller; William E Kraus; Clinton A Brawner; Christopher M O'Connor; David J Whellan; Lawton S Cooper; Jerome L Fleg; Dalane W Kitzman; Alain Cohen-Solal; James A Blumenthal; David S Rendall; Ileana L Piña;
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural     Date:  2012-10-10
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  60     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-02     Completed Date:  2013-01-09     Revised Date:  2013-11-14    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1899-905     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Affiliation:
Division of Cardiovascular Medicine, Henry Ford Hospital, 6525 Second Avenue, Detroit, Michigan 48202, USA. sketeyi1@hfhs.org
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00047437
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MeSH Terms
Descriptor/Qualifier:
Aged
Exercise / physiology*
Exercise Therapy / methods*
Female
Follow-Up Studies
Heart Failure / physiopathology*,  therapy*
Humans
Male
Middle Aged
Treatment Outcome
Grant Support
ID/Acronym/Agency:
U01 HL064250/HL/NHLBI NIH HHS
Comments/Corrections

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