Cited by 1,099Cardiovascular and exercise physiologyHeart Failure Treatment and ManagementCardiac Health and Mental Health

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Randomized, Controlled Trial of Long-Term Moderate Exercise Training in Chronic Heart Failure: Effects on Functional Capacity, Quality of Life, and Clinical Outcome

Belardinelli, Romualdo, Georgiou, Demetrios, Cianci, Giovanni, Purcaro, Augusto·1999·Circulation

DOI 10.1161/01.cir.99.9.1173

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Abstract

BACKGROUND: It is still a matter of debate whether exercise training (ET) is a beneficial treatment in chronic heart failure (CHF). METHODS AND RESULTS: To determine whether long-term moderate ET improves functional capacity and quality of life in patients with CHF and whether these effects translate into a favorable outcome, 110 patients with stable CHF were initially recruited, and 99 (59+/-14 years of age; 88 men and 11 women) were randomized into 2 groups. One group (group T, n=50) underwent ET at 60% of peak &f1;O2, initially 3 times a week for 8 weeks, then twice a week for 1 year. Another group (group NT, n=49) did not exercise. At baseline and at months 2 and 14, all patients underwent a cardiopulmonary exercise test, while 74 patients (37 in group T and 37 in group NT) with ischemic heart disease underwent myocardial scintigraphy. Quality of life was assessed by questionnaire. Ninety-four patients completed the protocol (48 in group T and 46 in group NT). Changes were observed only in patients in group T. Both peak &f1;O2 and thallium activity score improved at 2 months (18% and 24%, respectively; P<0. 001 for both) and did not change further after 1 year. Quality of life also improved and paralleled peak VO2. Exercise training was associated both with lower mortality (n=9 versus n=20 for those with training versus those without; relative risk (RR)=0.37; 95% CI, 0.17 to 0.84; P=0.01) and hospital readmission for heart failure (5 versus 14; RR=0.29; 95% CI, 0.11 to 0.88; P=0.02). Independent predictors of events were ventilatory threshold at baseline (beta-coefficient=0.378) and posttraining thallium activity score (beta-coefficient -0.165). CONCLUSIONS: Long-term moderate ET determines a sustained improvement in functional capacity and quality of life in patients with CHF. This benefit seems to translate into a favorable outcome.

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“For comparison of clinical outcomes, training patients had lower rates of HFrelated hospitalization and mortality (Belardinelli et al., 1999), but composites of hospitalization and mortality rates were not different from those of the control patients (McKelvie et al., 2002).”
Result
Improvement of exercise tolerance in cardiopulmonary testing with sustained safety after regular training in outpatients with systolic heart failure (NYHA III) and an implantable cardioverter-defibrillator. Prospective 18-month randomized study
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Self-citation
Team Management of Heart Failure: The Emerging Role of Exercise, and Implications for Cardiac Rehabilitation Centers
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Self-citation
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Authors: Belardinelli, R., Georgiou, D., Cianci, G., & Purcaro, A.
Affiliations: Columbia University (US)
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1999-03-09
Volume: 99
Issue: 9
Pages: 1173-1182
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/01.cir.99.9.1173
OpenAlex: W2136315725
Cited by: 1,099
References: 25
Citations by year: 2026: 9 · 2025: 20 · 2024: 19 · 2023: 16 · 2022: 26 · 2021: 31 · 2020: 25 · 2019: 25 · 2018: 30 · 2017: 36 · 2016: 37 · 2015: 48 · 2014: 34 · 2013: 38 · 2012: 53
FWCI: 101.26
Type: journal article
Language: en
Open access: closed
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Keywords: chronic heart failure, exercise training, moderate-intensity aerobic training, functional capacity, peak oxygen uptake, quality of life, myocardial perfusion, thallium scintigraphy, mortality, hospital readmission, ischemic heart disease, ventilatory threshold, prognostic factors
MeSH terms: Aged, Echocardiography, Exercise Therapy, Female, Heart Failure, Hemodynamics, Humans, Male, Middle Aged, Myocardium, Patient Readmission, Prospective Studies, Quality of Life, Radionuclide Imaging, Thallium Radioisotopes, Multivariate Analysis, Survival Analysis, Treatment Outcome

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Randomized, Controlled Trial of Long-Term Moderate Exercise Training in Chronic Heart Failure: Effects on Functional Capacity, Quality of Life, and Clinical Outcome

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