Benefits of exercise training in chronic heart failure

Tabet, Jean-Yves; Meurin, Philippe; Driss, Ahmed Ben; Weber, Hannelore; Renaud, Nathalie; Grosdemouge, Anne; Beauvais, Florence; Cohen‐Solal, Alain

doi:10.1016/j.acvd.2009.05.011

Cited by 77 publications

(46 citation statements)

References 56 publications

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“…In CHF patients, several studies have suggested that exercise training improves time to clinical worsening and survival [31,32]. In patients with CHF due to coronary artery disease, total mortality was reduced by 27% following exercise training [33].…”

Section: Discussionmentioning

confidence: 99%

Effect of Exercise and Respiratory Training on Clinical Progression and Survival in Patients with Severe Chronic Pulmonary Hypertension

et al. 2011

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Background: Even though specific agents for the treatment of patients with pulmonary hypertension (PH) are available, in PH patients, physical capacity and quality of life (QoL) are often restricted and survival is reduced. Objectives: This study prospectively investigated the long-term effects of respiratory and exercise training in patients with severe chronic PH regarding safety, time to clinical worsening and survival. Methods: Fifty-eight consecutive patients with severe PH on stable disease-targeted medication received exercise and respiratory training in hospital for 3 weeks and continued at home. They were prospectively followed for 24 ± 12 months. Primary endpoints were time to clinical worsening and survival. Adverse events and changes in the 6-min walking test, QoL, WHO functional class and gas exchange were secondary endpoints and were evaluated at baseline and at weeks 3 and 15. Results: All patients tolerated the exercise training well without severe adverse events. In week 15, 6-min walking test results were significantly improved compared to baseline (by 84 ± 49 m, p < 0.001), as well as QoL scores, WHO functional class (from 2.9 ± 0.5 to 2.6 ± 0.6, p < 0.01), peak oxygen consumption (from 12.5 ± 3.0 to 14.6 ± 3.9 ml/min/kg, p < 0.001), heart rate at rest (from 75 ± 12 to 61 ± 18 beats/min, p < 0.001) and maximal workload (from 65 ± 21 to 80 ± 25 W, p < 0.001). Survival at 1 and 2 years was 100 and 95%, respectively. Fifteen events occurred during the follow-up. Conclusion: This study indicates that exercise and respiratory training as add-on to medical treatment may improve exercise capacity and QoL, and that they have a good long-term safety in the described setting.

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Section: Discussionmentioning

confidence: 99%

Effect of Exercise and Respiratory Training on Clinical Progression and Survival in Patients with Severe Chronic Pulmonary Hypertension

et al. 2011

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“…Noncompliance with non-pharmacological treatment is related to adverse outcomes 2 and lower quality of life. 3 It is therefore vital to identify those patients who are at risk for noncompliance over a longer period of time, especially since studies have shown that noncompliance is a problem in the HF population. 4 It has been suggested that compliance with a specific recommendation might be a marker for compliance with other recommendations or lifestyle changes.…”

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confidence: 99%

Long-Term Compliance With Nonpharmacologic Treatment of Patients With Heart Failure

Nieuwenhuis

Jaarsma

Veldhuisen

et al. 2012

The American Journal of Cardiology

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The aim of this study was to examine long-term compliance with non-pharmacological treatment of patients with heart failure (HF) and its associated variables. Data of 648 hospitalized HF patients (mean age 69±12 years; 38% female; mean left ventricular ejection fraction [LVEF] 33±14%) were analyzed. Compliance was assessed by means of self-report at baseline and 1, 6, 12, and 18 months after discharge. Patients completed questionnaires on depressive symptoms, HF knowledge, and physical functioning at baseline. Logistic regression analyses were performed to examine independent associations with low long-term compliance. From baseline to 18 months at follow-up, long-term compliance with diet and fluid restriction ranged from 77%-91% and 72%-89% respectively. In contrast, compliance with daily weighing (34%-85%) and exercise (48%-64%) was lower. Patients who were in New York Heart Association (OR 3.55,), and less physical functioning (OR 0.99, were associated with low compliance with exercise. In conclusion, long-term compliance with exercise and daily weighing was lower than long-term compliance with advice on diet and fluid restriction. Although knowledge on HF and being offered educational support positively affected compliance with weighing and fluid restriction, these variables were not related to compliance with exercise. Therefore, new approaches to help HF patients stay physically active are needed. Key-words:Adherence; Compliance; Heart Failure; Non-Pharmacological Treatment. 3Although it has been well established, most studies on determinants of compliance in patients with heart failure (HF) are cross-sectional, or focus solely on compliance with 1 specific non-pharmacological recommendation. Data on temporal trends in compliance with cardiovascular medication have been reported previously 1 , but little is known about long-term compliance with non-pharmacological treatment (i.e., sodium-restricted diet, fluid restriction, daily weighing, and exercise) and its determinants. Noncompliance with non-pharmacological treatment is related to adverse outcomes 2 and lower quality of life. 3 It is therefore vital to identify those patients who are at risk for noncompliance over a longer period of time, especially since studies have shown that noncompliance is a problem in the HF population. 4 It has been suggested that compliance with a specific recommendation might be a marker for compliance with other recommendations or lifestyle changes. 5 Unfortunately, direct comparisons of compliance with different recommendations in the same study population are not available. The present study aims to address this gap by examining long-term compliance with nonpharmacological recommendations and by assessing variables associated with long-term compliance. MethodsThe study employed a descriptive, prospective design and used data from the COACH (Coordinating study evaluating Outcomes of Advising and Counseling in Heart failure) study.COACH was a randomized, multi-center, controlled study in which 1023 HF patient...

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“…However, the ExT was not initiated simultaneously with CRT, lasted only 3-months and no information on autonomic nervous system (ANS) or potential mechanisms were provided. In recent years, there has been a growing consensus that ExT has beneficial effects in CHF patients [16]. ExT in CHF produce meaningful change in VO 2peak with an expected average improvement of 17% [17].…”

Section: Effects Of Exercise Trainingmentioning

confidence: 99%

Imaging predictive factors and exercise training in CRT patients

Abreu

Santa-Clara

2016

Monaldi Arch Chest Dis

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Cardiac resynchronization therapy (CRT) is an established treatment for patients with moderate-to-severe chronic heart failure (CHF) and intraventricular conduction delay, which is identified by a QRS interval of 120 msec or more on a 12-lead electrocardiogram (ECG). CRT improves functional capacity, reduced hospitalizations for worsening CHF and increased survival, however, about 30-40% of patients who undergo CRT are non-responders with no clinical or echocardiographic improvement. Imaging parameters for prediction of CRT response have been reviewed. Cardiac magnetic resonance (CMR), recognized as the gold standard to assess viability, has shown to obtain good results regarding quantification of scar burden. CMR-derived measures of mechanical dyssynchrony appear to predict the outcome of CRT, however these have not been externally validated. Nuclear imaging techniques, namely single-photon emission cardiac tomography (SPECT) provide data on scar burden and location, left ventricular (LV) function, LV contraction and mechanical dyssynchrony from a single scan. The presence, location and burden of myocardial scar have been shown to affect response to CRT. However, compared to CMR, the low spatial resolution of scintigraphy might overestimate the scar extent. This problem can be overcome by positron emission tomography (PET). SPECT has also been used to quantify dyssynchrony, using phase analysis. Imaging investigation is ongoing, trying to better identify CRT non-responders. The combination of ExT in CRT has not been well investigated, however some data show that different aerobic exercise modes and intensities can further improve CRT benefits. Data available on the effects of ExT in patients with CRT have been reviewed.

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Benefits of exercise training in chronic heart failure

Cited by 77 publications

References 56 publications

Effect of Exercise and Respiratory Training on Clinical Progression and Survival in Patients with Severe Chronic Pulmonary Hypertension

Effect of Exercise and Respiratory Training on Clinical Progression and Survival in Patients with Severe Chronic Pulmonary Hypertension

Long-Term Compliance With Nonpharmacologic Treatment of Patients With Heart Failure

Imaging predictive factors and exercise training in CRT patients

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