Exercise training in heart failure

Abstract

Exercise training (ET) in heart failure (HF) has long been established as an important part of HF care. ET is known to improve quality of life and functional capacity in a number of ways. Despite its proposed benefits, evidence supporting its routine inclusion in standard rehabilitation programme is at times conflicting, partly because of the significant heterogeneity present in available randomised controlled trials. There is lack of evidence with regard to the duration of the overall benefit, the optimal exercise regimen and whether certain types of HF aetiologies benefit more than others. The aim of this review is to provide an update to date literature review of the positive and negative evidence surrounding ET in HF, while proposing an efficient novel in-hospital exercisebased rehabilitation programme for patients with HF in addition to a pre-existing HF clinic.

Exercise during transition from compensated left ventricular hypertrophy to heart failure in aortic stenosis rats

“…[3][4][5][6][7] Physical exercise in experimental heart failure attenuated ventricular dilation, cardiac dysfunction, increased passive stiffness, myocyte hypertrophy, myocardial fibrosis, myocyte calcium handling changes and mitochondrial dysfunction. [8][9][10][11][12][13] However, as most benefits of exercise have been described in experimental models of myocardial infarction-induced heart failure, [14][15][16][17] the effects of exercise during sustained LV pressure-overload remains poorly understood. In fact, studies performed in this experimental model have returned controversial results.…”

Cerebral blood flow alteration following acute myocardial infarction in mice

“…However, in disease state, a clinical study showed that physical exercise may impair cerebral perfusion in patients with chronic heart failure because of their reduced ability to increase CO [55]. Further investigation to disclose the impact of exercise on cerebral perfusion shortly after MI and before heart failure establishment is warranted especially when physical exercise is currently considered a standard rehabilitation program post-MI [56,57]. …”