BACKGROUND: Both endurance training (ET) and cardiac resynchronization therapy (CRT) improve quality of life (QOL) and exercise tolerance in patients with advanced chronic heart failure (CHF). DESIGN: A randomized intervention trial to study the effect on exercise capacity of ET in addition to CRT in patients with CHF and dyssynchrony. METHODS:Seventeen patients (eight men, aged 59+/-9 years) with CHF and dyssynchrony were randomized to CRT with (n=8) or without (n=9) ET and compared with two matched control CHF groups (standard care with ET: n=9, standard care only: n=10). At baseline and after 5 months, exercise tolerance, left ventricular (LV) remodelling, QOL and NT-pro brain natriuretic peptide (NT-proBNP) levels were assessed. RESULTS:Peak oxygen consumption (VO2peak), maximal workload (Wattmax), circulatory power, LV ejection fraction, dyssynchrony and QOL improved in both CRT groups. However, the increase in VO2peak (+40% versus +16%, P=0.005), Wattmax (+43% versus +13%, P=0.0005), and circulatory power (+74% versus +32%, P=0.01), was significantly greater in the trained versus the untrained CRT patients. Comparison of the four patient groups confirmed the cumulative effects of CRT plus ET. CONCLUSIONS: ET in resynchronized CHF patients is feasible and further enhances exercise tolerance. Patients with severe CHF should be prescribed an exercise training programme after implantation in order to maximize the expected benefit.
RCT Entities:
BACKGROUND: Both endurance training (ET) and cardiac resynchronization therapy (CRT) improve quality of life (QOL) and exercise tolerance in patients with advanced chronic heart failure (CHF). DESIGN: A randomized intervention trial to study the effect on exercise capacity of ET in addition to CRT in patients with CHF and dyssynchrony. METHODS: Seventeen patients (eight men, aged 59+/-9 years) with CHF and dyssynchrony were randomized to CRT with (n=8) or without (n=9) ET and compared with two matched control CHF groups (standard care with ET: n=9, standard care only: n=10). At baseline and after 5 months, exercise tolerance, left ventricular (LV) remodelling, QOL and NT-pro brain natriuretic peptide (NT-proBNP) levels were assessed. RESULTS: Peak oxygen consumption (VO2peak), maximal workload (Wattmax), circulatory power, LV ejection fraction, dyssynchrony and QOL improved in both CRT groups. However, the increase in VO2peak (+40% versus +16%, P=0.005), Wattmax (+43% versus +13%, P=0.0005), and circulatory power (+74% versus +32%, P=0.01), was significantly greater in the trained versus the untrained CRT patients. Comparison of the four patient groups confirmed the cumulative effects of CRT plus ET. CONCLUSIONS: ET in resynchronized CHFpatients is feasible and further enhances exercise tolerance. Patients with severe CHF should be prescribed an exercise training programme after implantation in order to maximize the expected benefit.
Authors: Gerson Cipriano; Vivian T F Cipriano; Vinicius Z Maldaner da Silva; Graziella F B Cipriano; Gaspar R Chiappa; Alexandra C G B de Lima; Lawrence P Cahalin; Ross Arena Journal: Heart Fail Rev Date: 2014-09 Impact factor: 4.214
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Authors: Daniel A Steinhaus; Steven A Lubitz; Peter A Noseworthy; Daniel B Kramer Journal: J Cardiopulm Rehabil Prev Date: 2019-09 Impact factor: 2.081
Authors: Jerome L Fleg; Lawton S Cooper; Barry A Borlaug; Mark J Haykowsky; William E Kraus; Benjamin D Levine; Marc A Pfeffer; Ileana L Piña; David C Poole; Gordon R Reeves; David J Whellan; Dalane W Kitzman Journal: Circ Heart Fail Date: 2015-01 Impact factor: 8.790
Authors: Philip A Ades; Steven J Keteyian; Gary J Balady; Nancy Houston-Miller; Dalane W Kitzman; Donna M Mancini; Michael W Rich Journal: JACC Heart Fail Date: 2013-10-24 Impact factor: 12.035