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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
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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“Whether these physiological adaptations will ultimately reduce mortality and morbidity is yet to be determined by a large prospective trial, although there is at least one small trial which showed a reduction in hospitalizations and improved 1-year survival.41”
From Exercise and Physical Activity in the Prevention and Treatment of Atherosclerotic Cardiovascular Disease: A Statement From the Council on Clinical Cardiology (Subcommittee on Exercise, Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity) (2003) · cites this paper as [41]
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Metadata
- Authors
- Belardinelli, R., Georgiou, D., Cianci, G., & Purcaro, A.
- Affiliations
- Columbia University (US)
- Venue
- Circulation
- Published
- 1999-03-09
- Volume
- 99
- Issue
- 9
- Pages
- 1173-1182
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- 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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