Exercise Training as a Therapy for Chronic Heart Failure: Can Older People Benefit?

Abstract

Despite recent advances in pharmacological therapy, chronic heart failure remains a major cause of morbidity and mortality in older people. Studies of exercise training in younger, carefully selected patients with heart failure have shown improvements in symptoms and exercise capacity and in many pathophysiological aspects of heart failure, including skeletal myopathy, ergoreceptor function, heart rate variability, endothelial function, and cytokine expression. Data on mortality and hospitalization are lacking, and effects on everyday activity, depression, and quality of life are unclear. Exercise therapy for patients with heart failure appears to be safe and has the potential to improve function and quality of life in older people with heart failure. To realize these potential benefits, exercise programs that are suitable for older, frail people need to be established and tested in an older, frail, unselected population with comorbidities.

Clinical outcomes of a cardiac rehabilitation and maintenance program for Chinese patients with congestive heart failure

“…In accord with other reports [16,22], our patients have demonstrated significant improvements in both physical and emotional domain scores in the CHQ-c, suggesting an improved quality of life with an improved psychosocial outlook [23].…”

Feasibility of Conducting a 6-Months Long Home-based Exercise Program with Protein Supplementation in Elderly Community-dwelling Individuals with Heart Failure

“…Furthermore, exercise has been shown to improve HF symptoms [33]. However, elderly patients frequently have several barriers for starting an exercise program and continuing it on a regular basis.…”

Relevância e tratamento das lesões características da insuficiência cardíaca na musculatura esquelética

“…[81][82][83][84] O treinamento físico também pode reverter muitas das características da miopatia esquelética da insuficiência cardíaca, como mudança no tipo de fibra muscular, atrofia, apoptose e vasoconstrição. 85 Witham et al (2003) 86 mostraram ainda melhora na capacidade de realização de atividade fí-sica, diminuição dos sintomas e na atividade dos mecanorreceptores, redução na atividade nervosa simpática concomitante ao aumento na parassimpática, decréscimo na expressão de iNOS e citocinas pró-inflamatórias e, na musculatura esquelética, aumento na capacidade de geração de força, na área de secção transversa da fibra, na tolerância à fadiga, no número de mitocôndrias, no número de capilares por fibra e na atividade de inúmeras enzimas importantes ao metabolismo.…”