Exercise training effects on elderly and middle-age patients with chronic heart failure after acute decompensation: A randomized, controlled trial

Domenico Acanfora, Pietro Scicchitano, Gerardo Casucci, Bernardo Lanzillo, Nicola Capuano, Giuseppe Furgi, Chiara Acanfora, Marialaura Longobardi, Raffaele Antonelli Incalzi, Giuseppe Piscosquito, Marco Matteo Ciccone

Research output: Contribution to journalArticle

Abstract

Background The aim of this study was to evaluate the effect of exercise training on cardiac function in heart failure (HF) patients recently suffering from acute decompensation. Radionuclide ambulatory ventricular function monitoring (VEST) was used to detect variations in cardiac hemodynamics during training period. Methods This was a monocentric, randomized, controlled trial. We enrolled 72 HF patients [left ventricle ejection fraction (LVEF) < 40%] within two weeks after acute cardiogenic pulmonary edema: 40 in the elderly group, 32 in the middle-aged group. Trained patients underwent a specific four-weeks exercise program (closed-chain resistive activities and abdominal exercises) which was supervised by a therapist in agreement with patients’ characteristics. Catecholamines at rest, echocardiography, right-heart catheterization, and bicycle ergometer were performed. VEST was performed at the end of the 4 weeks-training in all patients in order to assess patients’ cardiac hemodynamics [LVEF, cardiac output (CO), stroke volume]. Results Exercise training significantly improved exercise duration, peak oxygen consumption, and ventilatory threshold both in elderly and middle-aged patients (p < 0.0001) after the 4-week controlled training. Despite age (F = 35.086, p < 0.0001; F = 16.967, p < 0.0001; F = 42.574, p = 0.03, respectively), training reliably influence previous cardiopulmonary parameters (F = 29.402, F = 16.421, F = 26.80, p < 0.0001, respectively). Norepinephrine and epinephrine were significantly reduced in both trained groups. Peak LVEF (37.3 ± 4.7% vs 34 ± 6.2%, p = 0.002), peak stroke volume (43.3 ± 3.9% vs 37.5 ± 4.3%, p = 0.001), and peak CO (63.4 ± 6.1% vs 48.2 ± 4.7%, p < 0.0001) increased in middle-aged patients after 4-week training. Conclusions Exercise training improves cardiac performance indexes and pulmonary function in both middle-aged and elderly HF patients early after an acute episode of cardiac decompensation.

Original languageEnglish
Pages (from-to)313-323
Number of pages11
JournalInternational Journal of Cardiology
Volume225
DOIs
Publication statusPublished - Dec 15 2016

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Randomized Controlled Trials
Heart Failure
Exercise
Heart Ventricles
Cardiac Output
Stroke Volume
Hemodynamics
Ventricular Function
Pulmonary Edema
Cardiac Catheterization
Oxygen Consumption
Radioisotopes
Epinephrine
Catecholamines
Echocardiography
Norepinephrine
Lung

Keywords

  • Acute decompensation
  • Elderly
  • Exercise training
  • Heart failure
  • Middle age

ASJC Scopus subject areas

  • Medicine(all)
  • Cardiology and Cardiovascular Medicine

Cite this

Exercise training effects on elderly and middle-age patients with chronic heart failure after acute decompensation : A randomized, controlled trial. / Acanfora, Domenico; Scicchitano, Pietro; Casucci, Gerardo; Lanzillo, Bernardo; Capuano, Nicola; Furgi, Giuseppe; Acanfora, Chiara; Longobardi, Marialaura; Incalzi, Raffaele Antonelli; Piscosquito, Giuseppe; Ciccone, Marco Matteo.

In: International Journal of Cardiology, Vol. 225, 15.12.2016, p. 313-323.

Research output: Contribution to journalArticle

Acanfora, Domenico ; Scicchitano, Pietro ; Casucci, Gerardo ; Lanzillo, Bernardo ; Capuano, Nicola ; Furgi, Giuseppe ; Acanfora, Chiara ; Longobardi, Marialaura ; Incalzi, Raffaele Antonelli ; Piscosquito, Giuseppe ; Ciccone, Marco Matteo. / Exercise training effects on elderly and middle-age patients with chronic heart failure after acute decompensation : A randomized, controlled trial. In: International Journal of Cardiology. 2016 ; Vol. 225. pp. 313-323.
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abstract = "Background The aim of this study was to evaluate the effect of exercise training on cardiac function in heart failure (HF) patients recently suffering from acute decompensation. Radionuclide ambulatory ventricular function monitoring (VEST) was used to detect variations in cardiac hemodynamics during training period. Methods This was a monocentric, randomized, controlled trial. We enrolled 72 HF patients [left ventricle ejection fraction (LVEF) < 40{\%}] within two weeks after acute cardiogenic pulmonary edema: 40 in the elderly group, 32 in the middle-aged group. Trained patients underwent a specific four-weeks exercise program (closed-chain resistive activities and abdominal exercises) which was supervised by a therapist in agreement with patients’ characteristics. Catecholamines at rest, echocardiography, right-heart catheterization, and bicycle ergometer were performed. VEST was performed at the end of the 4 weeks-training in all patients in order to assess patients’ cardiac hemodynamics [LVEF, cardiac output (CO), stroke volume]. Results Exercise training significantly improved exercise duration, peak oxygen consumption, and ventilatory threshold both in elderly and middle-aged patients (p < 0.0001) after the 4-week controlled training. Despite age (F = 35.086, p < 0.0001; F = 16.967, p < 0.0001; F = 42.574, p = 0.03, respectively), training reliably influence previous cardiopulmonary parameters (F = 29.402, F = 16.421, F = 26.80, p < 0.0001, respectively). Norepinephrine and epinephrine were significantly reduced in both trained groups. Peak LVEF (37.3 ± 4.7{\%} vs 34 ± 6.2{\%}, p = 0.002), peak stroke volume (43.3 ± 3.9{\%} vs 37.5 ± 4.3{\%}, p = 0.001), and peak CO (63.4 ± 6.1{\%} vs 48.2 ± 4.7{\%}, p < 0.0001) increased in middle-aged patients after 4-week training. Conclusions Exercise training improves cardiac performance indexes and pulmonary function in both middle-aged and elderly HF patients early after an acute episode of cardiac decompensation.",
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author = "Domenico Acanfora and Pietro Scicchitano and Gerardo Casucci and Bernardo Lanzillo and Nicola Capuano and Giuseppe Furgi and Chiara Acanfora and Marialaura Longobardi and Incalzi, {Raffaele Antonelli} and Giuseppe Piscosquito and Ciccone, {Marco Matteo}",
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T1 - Exercise training effects on elderly and middle-age patients with chronic heart failure after acute decompensation

T2 - A randomized, controlled trial

AU - Acanfora, Domenico

AU - Scicchitano, Pietro

AU - Casucci, Gerardo

AU - Lanzillo, Bernardo

AU - Capuano, Nicola

AU - Furgi, Giuseppe

AU - Acanfora, Chiara

AU - Longobardi, Marialaura

AU - Incalzi, Raffaele Antonelli

AU - Piscosquito, Giuseppe

AU - Ciccone, Marco Matteo

PY - 2016/12/15

Y1 - 2016/12/15

N2 - Background The aim of this study was to evaluate the effect of exercise training on cardiac function in heart failure (HF) patients recently suffering from acute decompensation. Radionuclide ambulatory ventricular function monitoring (VEST) was used to detect variations in cardiac hemodynamics during training period. Methods This was a monocentric, randomized, controlled trial. We enrolled 72 HF patients [left ventricle ejection fraction (LVEF) < 40%] within two weeks after acute cardiogenic pulmonary edema: 40 in the elderly group, 32 in the middle-aged group. Trained patients underwent a specific four-weeks exercise program (closed-chain resistive activities and abdominal exercises) which was supervised by a therapist in agreement with patients’ characteristics. Catecholamines at rest, echocardiography, right-heart catheterization, and bicycle ergometer were performed. VEST was performed at the end of the 4 weeks-training in all patients in order to assess patients’ cardiac hemodynamics [LVEF, cardiac output (CO), stroke volume]. Results Exercise training significantly improved exercise duration, peak oxygen consumption, and ventilatory threshold both in elderly and middle-aged patients (p < 0.0001) after the 4-week controlled training. Despite age (F = 35.086, p < 0.0001; F = 16.967, p < 0.0001; F = 42.574, p = 0.03, respectively), training reliably influence previous cardiopulmonary parameters (F = 29.402, F = 16.421, F = 26.80, p < 0.0001, respectively). Norepinephrine and epinephrine were significantly reduced in both trained groups. Peak LVEF (37.3 ± 4.7% vs 34 ± 6.2%, p = 0.002), peak stroke volume (43.3 ± 3.9% vs 37.5 ± 4.3%, p = 0.001), and peak CO (63.4 ± 6.1% vs 48.2 ± 4.7%, p < 0.0001) increased in middle-aged patients after 4-week training. Conclusions Exercise training improves cardiac performance indexes and pulmonary function in both middle-aged and elderly HF patients early after an acute episode of cardiac decompensation.

AB - Background The aim of this study was to evaluate the effect of exercise training on cardiac function in heart failure (HF) patients recently suffering from acute decompensation. Radionuclide ambulatory ventricular function monitoring (VEST) was used to detect variations in cardiac hemodynamics during training period. Methods This was a monocentric, randomized, controlled trial. We enrolled 72 HF patients [left ventricle ejection fraction (LVEF) < 40%] within two weeks after acute cardiogenic pulmonary edema: 40 in the elderly group, 32 in the middle-aged group. Trained patients underwent a specific four-weeks exercise program (closed-chain resistive activities and abdominal exercises) which was supervised by a therapist in agreement with patients’ characteristics. Catecholamines at rest, echocardiography, right-heart catheterization, and bicycle ergometer were performed. VEST was performed at the end of the 4 weeks-training in all patients in order to assess patients’ cardiac hemodynamics [LVEF, cardiac output (CO), stroke volume]. Results Exercise training significantly improved exercise duration, peak oxygen consumption, and ventilatory threshold both in elderly and middle-aged patients (p < 0.0001) after the 4-week controlled training. Despite age (F = 35.086, p < 0.0001; F = 16.967, p < 0.0001; F = 42.574, p = 0.03, respectively), training reliably influence previous cardiopulmonary parameters (F = 29.402, F = 16.421, F = 26.80, p < 0.0001, respectively). Norepinephrine and epinephrine were significantly reduced in both trained groups. Peak LVEF (37.3 ± 4.7% vs 34 ± 6.2%, p = 0.002), peak stroke volume (43.3 ± 3.9% vs 37.5 ± 4.3%, p = 0.001), and peak CO (63.4 ± 6.1% vs 48.2 ± 4.7%, p < 0.0001) increased in middle-aged patients after 4-week training. Conclusions Exercise training improves cardiac performance indexes and pulmonary function in both middle-aged and elderly HF patients early after an acute episode of cardiac decompensation.

KW - Acute decompensation

KW - Elderly

KW - Exercise training

KW - Heart failure

KW - Middle age

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