Abstract
Background. Beneficial effects of physical training on exercise tolerance, autonomic and skeletal muscle function and limb blood flow have been demonstrated in chronic heart failure. Because this rehabilitation is expensive, may involve risk, and has unknown effects on prognosis, the possibility of predicting benefit on the basis of individual patient data is intriguing. The most suitable exercise training programme has not yet been established. Methods and Results. We reviewed the progress of 134 stable heart failure patients studied in randomized controlled trials of physical training. A significant training effect (+13% peak oxygen consumption, +17% exercise duration) was associated with improved autonomic indices (resting catecholamines and hormones, heart rate variability), without significant side-effects. No ventilatory, haemodynamic, autonomic or clinical factor at baseline was a predictor of outcome. Similar beneficial effects were observed in both male and female patients. The improvement in oxygen consumption after 16 weeks training was higher than after 6 weeks (+2.6 ± 3.0 vs +0.3 ± 3.1 ml.kg.min-1, P <0.05). The combination of cycle ergometer with calisthenic exercises was more beneficial than cycle ergometer alone (+2.7 ± 4.2 vs 1.2 ± 2.0 ml.kg.min-1, P <0.01). The presence of non-sustained ventricular tachycardia did not preclude a training effect. Patients older than 70 years were able to train, although less effectively than the younger ones. No difference in exercise gain was observed whether the patients trained in the hospital or at home. Conclusion. The positive effects of physical rehabilitation in chronic stable heart failure patients are confirmed. No baseline patient factor was significantly correlated with outcome. A tailored, moderate, home-based, combined cycle ergometer, plus calisthenic exercise training seems safe and beneficial in a large cohort of heart failure patients, with similar benefits in a variety of conditions and different hospital settings.
| Original language | English |
|---|---|
| Pages (from-to) | 466-475 |
| Number of pages | 10 |
| Journal | European Heart Journal |
| Volume | 19 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Mar 1998 |
Fingerprint
Keywords
- Autonomic control
- Exercise
- Haemodynamics
- Heart failure
- Rehabilitation
- Ventilation
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Experience from controlled trials of physical training in chronic heart failure. Protocol and patient factors in effectiveness in the improvement in exercise tolerance. / Piepoli, Massimo; Maugeri, Fondazione S.; Campana, M.; Ferrari, R.; Giordano, A.; Scalvini, S.; Volterrani, M.; Bernardi, L.; Calciati, A.; Finardi, G.; Perlini, S.; Radaelli, A.; Soldà, P. L.; Adamopoulos, S.; Chua, T. P.; Poole-Wilson, P. A.; Webb-Peploe, K.; Barlow, C.; Coats, A. J S; Conway, J.; Davey, P. P.; Meyer, T. E.; Paterson, D. J.; Robbins, P.; Sleight, P.; Kára, T.; Souce, M.; Spinarová, L.; Stejfa, M.; Toman, J.; Zatloukal, B.; Ponikowski, P.; Szelemery, R.; Wrabec, K.
In: European Heart Journal, Vol. 19, No. 3, 03.1998, p. 466-475.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Experience from controlled trials of physical training in chronic heart failure. Protocol and patient factors in effectiveness in the improvement in exercise tolerance
AU - Piepoli, Massimo
AU - Maugeri, Fondazione S.
AU - Campana, M.
AU - Ferrari, R.
AU - Giordano, A.
AU - Scalvini, S.
AU - Volterrani, M.
AU - Bernardi, L.
AU - Calciati, A.
AU - Finardi, G.
AU - Perlini, S.
AU - Radaelli, A.
AU - Soldà, P. L.
AU - Adamopoulos, S.
AU - Chua, T. P.
AU - Poole-Wilson, P. A.
AU - Webb-Peploe, K.
AU - Barlow, C.
AU - Coats, A. J S
AU - Conway, J.
AU - Davey, P. P.
AU - Meyer, T. E.
AU - Paterson, D. J.
AU - Robbins, P.
AU - Sleight, P.
AU - Kára, T.
AU - Souce, M.
AU - Spinarová, L.
AU - Stejfa, M.
AU - Toman, J.
AU - Zatloukal, B.
AU - Ponikowski, P.
AU - Szelemery, R.
AU - Wrabec, K.
PY - 1998/3
Y1 - 1998/3
N2 - Background. Beneficial effects of physical training on exercise tolerance, autonomic and skeletal muscle function and limb blood flow have been demonstrated in chronic heart failure. Because this rehabilitation is expensive, may involve risk, and has unknown effects on prognosis, the possibility of predicting benefit on the basis of individual patient data is intriguing. The most suitable exercise training programme has not yet been established. Methods and Results. We reviewed the progress of 134 stable heart failure patients studied in randomized controlled trials of physical training. A significant training effect (+13% peak oxygen consumption, +17% exercise duration) was associated with improved autonomic indices (resting catecholamines and hormones, heart rate variability), without significant side-effects. No ventilatory, haemodynamic, autonomic or clinical factor at baseline was a predictor of outcome. Similar beneficial effects were observed in both male and female patients. The improvement in oxygen consumption after 16 weeks training was higher than after 6 weeks (+2.6 ± 3.0 vs +0.3 ± 3.1 ml.kg.min-1, P <0.05). The combination of cycle ergometer with calisthenic exercises was more beneficial than cycle ergometer alone (+2.7 ± 4.2 vs 1.2 ± 2.0 ml.kg.min-1, P <0.01). The presence of non-sustained ventricular tachycardia did not preclude a training effect. Patients older than 70 years were able to train, although less effectively than the younger ones. No difference in exercise gain was observed whether the patients trained in the hospital or at home. Conclusion. The positive effects of physical rehabilitation in chronic stable heart failure patients are confirmed. No baseline patient factor was significantly correlated with outcome. A tailored, moderate, home-based, combined cycle ergometer, plus calisthenic exercise training seems safe and beneficial in a large cohort of heart failure patients, with similar benefits in a variety of conditions and different hospital settings.
AB - Background. Beneficial effects of physical training on exercise tolerance, autonomic and skeletal muscle function and limb blood flow have been demonstrated in chronic heart failure. Because this rehabilitation is expensive, may involve risk, and has unknown effects on prognosis, the possibility of predicting benefit on the basis of individual patient data is intriguing. The most suitable exercise training programme has not yet been established. Methods and Results. We reviewed the progress of 134 stable heart failure patients studied in randomized controlled trials of physical training. A significant training effect (+13% peak oxygen consumption, +17% exercise duration) was associated with improved autonomic indices (resting catecholamines and hormones, heart rate variability), without significant side-effects. No ventilatory, haemodynamic, autonomic or clinical factor at baseline was a predictor of outcome. Similar beneficial effects were observed in both male and female patients. The improvement in oxygen consumption after 16 weeks training was higher than after 6 weeks (+2.6 ± 3.0 vs +0.3 ± 3.1 ml.kg.min-1, P <0.05). The combination of cycle ergometer with calisthenic exercises was more beneficial than cycle ergometer alone (+2.7 ± 4.2 vs 1.2 ± 2.0 ml.kg.min-1, P <0.01). The presence of non-sustained ventricular tachycardia did not preclude a training effect. Patients older than 70 years were able to train, although less effectively than the younger ones. No difference in exercise gain was observed whether the patients trained in the hospital or at home. Conclusion. The positive effects of physical rehabilitation in chronic stable heart failure patients are confirmed. No baseline patient factor was significantly correlated with outcome. A tailored, moderate, home-based, combined cycle ergometer, plus calisthenic exercise training seems safe and beneficial in a large cohort of heart failure patients, with similar benefits in a variety of conditions and different hospital settings.
KW - Autonomic control
KW - Exercise
KW - Haemodynamics
KW - Heart failure
KW - Rehabilitation
KW - Ventilation
UR - http://www.scopus.com/inward/record.url?scp=0032030650&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0032030650&partnerID=8YFLogxK
U2 - 10.1053/euhj.1997.0736
DO - 10.1053/euhj.1997.0736
M3 - Article
C2 - 9568451
AN - SCOPUS:0032030650
VL - 19
SP - 466
EP - 475
JO - European Heart Journal
JF - European Heart Journal
SN - 0195-668X
IS - 3
ER -