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Excerpt
Background. The benefits of exercise training (ET) for patients with chronic heart failure (CHF) are still debated. This study investigates long-term moderate exercise training in patients with stable CHF.
Methods. Ninety-nine patients with EF ≤ 40% were randomized either to ET at 60% of peak VO2 3 times a week for 8 weeks, followed by 2 times a week for 1 year (T, n = 50) or a nonexercising group (NT, n = 49). All patients had cardiopulmonary exercise testing at baseline, 2 months, and 14 months. Myocardial thallium scintigraphy was performed in 37 patients in each group. Quality of life was assessed by questionnaire.
Results. Baseline peak VO2 was similar between the groups (T = 15.7 ± 2, NT = 15.2 ± 2 ml/kg/min). Peak VO2 (↑18%), thallium activity score (↑24%), and quality of life improved at 2 months only in the trained group and the effect was maintained after 1 year. During more than 3 years of follow-up, ET as associated with lower mortality and hospital readmission for CHF.
Conclusion. Long-term moderate ET improves functional capacity, myocardial perfusion, and quality of life and is associated with improved outcomes.
Comment. This randomized, controlled study documents improved outcomes for stable CHF patients after long-term moderate ET and adds to existing data to prompt a mortality trial of ET in CHF.
