BACKGROUND:Physical training is a well-known complementary treatment for chronic heart failure (CHF); however, many aspects require further studies. One of them is the impact on remodeling of the left ventricle (LV). The purpose of this study was to evaluate the effect of 6 months of training on LV, exercise capacity and safety issues in patients with ischemic CHF. METHODS:Fifty patients (mean age 60.1+/-9.2 years) with ischemic CHF, New York Heart Association (NYHA) classification class II and III and left ventricular ejection fraction (LVEF) <or=35% were randomized into groups: undergoing 6-month training (25 patients) and not trained (25 patients). In both groups at baseline and at 6 months a cardiopulmonary exercise test and magnetic resonance imaging (MRI) with evaluation of LV were performed. Training was limited by the achievement of 80% of the predicted heart rate at VO2peak achieved at the baseline cardiopulmonary exercise test. RESULTS: All patients completed the 6-month observation. No serious adverse events were found in either group. Exercise capacity improved only in the trained group (VO2peak increased by 31%). At 6 months in the trained group there was a tendency towards an improvement in some LV parameters: ejection fraction, end-diastolic volume and wall motion score index (WMSI), whereas an opposite trend was seen in the controls (P<0.05, P<0.05 and P<0.01 for comparison of LVEFs, end-diastolic volumes and WMSIs, respectively). CONCLUSIONS: Six-month training in ischemic CHF patients is a safe modality. Training improves exercise capacity. There was no negative impact on LV morphology, and a trend towards improvement of functional parameters on MRI may suggest an anti-remodeling effect of training in patients with ischemic CHF.
RCT Entities:
BACKGROUND: Physical training is a well-known complementary treatment for chronic heart failure (CHF); however, many aspects require further studies. One of them is the impact on remodeling of the left ventricle (LV). The purpose of this study was to evaluate the effect of 6 months of training on LV, exercise capacity and safety issues in patients with ischemic CHF. METHODS: Fifty patients (mean age 60.1+/-9.2 years) with ischemic CHF, New York Heart Association (NYHA) classification class II and III and left ventricular ejection fraction (LVEF) <or=35% were randomized into groups: undergoing 6-month training (25 patients) and not trained (25 patients). In both groups at baseline and at 6 months a cardiopulmonary exercise test and magnetic resonance imaging (MRI) with evaluation of LV were performed. Training was limited by the achievement of 80% of the predicted heart rate at VO2peak achieved at the baseline cardiopulmonary exercise test. RESULTS: All patients completed the 6-month observation. No serious adverse events were found in either group. Exercise capacity improved only in the trained group (VO2peak increased by 31%). At 6 months in the trained group there was a tendency towards an improvement in some LV parameters: ejection fraction, end-diastolic volume and wall motion score index (WMSI), whereas an opposite trend was seen in the controls (P<0.05, P<0.05 and P<0.01 for comparison of LVEFs, end-diastolic volumes and WMSIs, respectively). CONCLUSIONS: Six-month training in ischemic CHFpatients is a safe modality. Training improves exercise capacity. There was no negative impact on LV morphology, and a trend towards improvement of functional parameters on MRI may suggest an anti-remodeling effect of training in patients with ischemic CHF.
Authors: Rod S Taylor; Sarah Walker; Neil A Smart; Massimo F Piepoli; Fiona C Warren; Oriana Ciani; David Whellan; Christopher O'Connor; Steven J Keteyian; Andrew Coats; Constantinos H Davos; Hasnain M Dalal; Kathleen Dracup; Lorraine S Evangelista; Kate Jolly; Jonathan Myers; Birgitta B Nilsson; Claudio Passino; Miles D Witham; Gloria Y Yeh Journal: J Am Coll Cardiol Date: 2019-04-02 Impact factor: 24.094
Authors: Rod S Taylor; Sarah Walker; Neil A Smart; Massimo F Piepoli; Fiona C Warren; Oriana Ciani; Christopher O'Connor; David Whellan; Steven J Keteyian; Andrew Coats; Constantinos H Davos; Hasnain M Dalal; Kathleen Dracup; Lorraine Evangelista; Kate Jolly; Jonathan Myers; Robert S McKelvie; Birgitta B Nilsson; Claudio Passino; Miles D Witham; Gloria Y Yeh; Ann-Dorthe O Zwisler Journal: Eur J Heart Fail Date: 2018-09-26 Impact factor: 15.534
Authors: Francisco V Santos; Gaspar R Chiappa; Sergio Henrique Rodolpho Ramalho; Alexandra Correa Gervazoni Balbuena de Lima; Fausto Stauffer Junqueira de Souza; Lawrence P Cahalin; João Luiz Quagliotti Durigan; Isac de Castro; Gerson Cipriano Journal: Heart Fail Rev Date: 2018-01 Impact factor: 4.214
Authors: Edward J Davies; Tiffany Moxham; Karen Rees; Sally Singh; Andrew J S Coats; Shah Ebrahim; Fiona Lough; Rod S Taylor Journal: Eur J Heart Fail Date: 2010-05-21 Impact factor: 15.534
Authors: Wesley J Tucker; Rhys I Beaudry; Yuanyuan Liang; Alexander M Clark; Corey R Tomczak; Michael D Nelson; Oyvind Ellingsen; Mark J Haykowsky Journal: Prog Cardiovasc Dis Date: 2018-09-15 Impact factor: 8.194