Physical training as a therapeutic measure in chronic heart failure: time for recommendations

Tavazzi, Luigi; Giannuzzi, P

doi:10.1136/heart.86.1.7

Cited by 16 publications

(18 citation statements)

References 32 publications

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“…Despite the increased attention given to exercise training in CHF patients, standard guidelines have not been fully established and even in recent studies, exercise intensities and frequencies vary from 50% to 80% of maximum oxygen consumption and 3-7 days per week, respectively. 39 The present study employed the same exercise pro-gram as we use in clinical practice for CHF patients. More frequent exercise training might have given a systemic vascular effect in addition to the predominantly local effect in the trained extremities.…”

Section: Training Programmentioning

confidence: 99%

Exercise Training in Patients With Chronic Heart Failure Improves Endothelial Function Predominantly in the Trained Extremities

Kobayashi

Tsuruya²,

Iwasawa

et al. 2003

Circ J

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The present study investigates whether lower-limb dominant exercise training in patients with chronic heart failure (CHF) improves endothelial function primarily in the trained lower extremities or equally in the upper and lower extremities. Twenty-eight patients with CHF were randomized to the exercise or control group. The exercise group underwent cycle ergometer training for 3 months while controls continued an inactive sedentary lifestyle. Exercise capacity (6-min walk test) and flow-mediated vasodilation in the brachial and posterior tibial arteries were evaluated. After 3 months, walking performance increased only in the exercise group (488+/-16 to 501+/-14 m [control]; 497+/-23 to 567+/-39 m [exercise, p<0.05]). The flow-mediated vasodilation in the brachial arteries did not change in either group (4.2+/-0.5 to 4.5+/-0.4% [control]; 4.3+/-0.5 to 4.6+/-0.4% [exercise]), but that in the posterior tibial arteries increased only in the exercise group (4.1+/-0.5 to 4.1+/-0.3% [control]; 3.6+/-0.3 to 6.4+/-0.6% [exercise, p<0.01]). Cycle ergometer training improved flow-mediated vasodilation in the trained lower limbs, but not in the untrained upper limbs. Exercise training appears to correct endothelial dysfunction predominantly by a local effect in the trained extremities.

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Section: Training Programmentioning

confidence: 99%

Exercise Training in Patients With Chronic Heart Failure Improves Endothelial Function Predominantly in the Trained Extremities

Kobayashi

Tsuruya²,

Iwasawa

et al. 2003

Circ J

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“…Physical training should be considered 6 as adjunct therapy for patients with chronic heart failure. Recent data have shown that exercise is considered beneficial for these patients in terms of improved mortality and morbidity, quality of life, functional capacity and improved cardiac and vascular function.…”

Section: Introductionmentioning

confidence: 99%

Effects of home-based exercise training for patients with chronic heart failure and sleep apnoea: a randomized comparison of two different programmes

et al. 2011

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“…Moreover, skeletal muscle dysfunction in CHF experiments great benefits with regular physical training, even if the function of the heart remains unaffected by exercise. In many HF subjects, the limitation in skeletal muscle function is more predominant than the hemodynamic impairment due to the cardiac dysfunction (119). In these patients the reduction of the functional capacity may lead to a progressive reduction of the mobility; this condition has shown to increase the risk of appearance of other chronic diseases.…”

Section: Congestive Hfmentioning

confidence: 99%

“…In these patients the reduction of the functional capacity may lead to a progressive reduction of the mobility; this condition has shown to increase the risk of appearance of other chronic diseases. The worsening of the health status due to the multiple comorbidities causes further exercise restriction and increased hospitalization and mortality in individuals with symptomatic HF (119). It is recognized that the reductions in physical capacity in CHF are not just secondary to alterations in myocardial function (120).…”

Section: Congestive Hfmentioning

confidence: 99%

New insights about the putative role of myokines in the context of cardiac rehabilitation and secondary cardiovascular prevention

et al. 2017

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Exercise training prevents the onset and the development of many chronic diseases, acting as an effective tool both for primary and for secondary prevention. Various mechanisms that may be the effectors of these beneficial effects have been proposed during the past decades: some of these are well recognized, others less. Muscular myokines, released during and after muscular contraction, have been proposed as key mediators of the systemic effects of the exercise. Nevertheless the availability of an impressive amount of evidence regarding the systemic effects of muscle-derived factors, few studies have examined key issues: (I) if skeletal muscle cells themselves are the main source of cytokine during exercise; (II) if the release of myokines into the systemic circulation reach an adequate concentration to provide significant effects in tissues far from skeletal muscle; (III) what may be the role carried out by muscular cytokine regarding the well-known benefits induced by regular exercise, first of all the anti-inflammatory effect of exercise. Furthermore, a greater part of our knowledge regarding myokines derives from the muscle of healthy subjects. This knowledge may not necessarily be transferred per se to subjects with chronic diseases implicating a direct or indirect muscular dysfunction and/or a chronic state of inflammation with persistent immune-inflammatory activation (and therefore increased circulating levels of some cytokines): cachexia, sarcopenia due to multiple factors, disability caused by neurological damage, chronic congestive heart failure (CHF) or coronary artery disease (CAD). A key point of future studies is to ascertain how is modified the muscular release of myokines in different categories of unhealthy subjects, both at baseline and after rehabilitation. The purpose of this review is to discuss the main findings on the role of myokines as putative mediators of the therapeutic benefits obtained through regular exercise in the context of secondary cardiovascular prevention.

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Physical training as a therapeutic measure in chronic heart failure: time for recommendations

Cited by 16 publications

References 32 publications

Exercise Training in Patients With Chronic Heart Failure Improves Endothelial Function Predominantly in the Trained Extremities

Exercise Training in Patients With Chronic Heart Failure Improves Endothelial Function Predominantly in the Trained Extremities

Effects of home-based exercise training for patients with chronic heart failure and sleep apnoea: a randomized comparison of two different programmes

New insights about the putative role of myokines in the context of cardiac rehabilitation and secondary cardiovascular prevention

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