Randomized, Controlled Trial of Long-Term Moderate Exercise Training in Chronic Heart Failure. Effects on Functional Capacity, Quality of Life, and Clinical Outcome.

Belardinelli, Romualdo; Georgiou, Demetrios; Cianci, G.; Purcaro, A

doi:10.1097/01823246-199910020-00016

Cited by 81 publications

(144 citation statements)

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“…The number of patients ranged from 27 to 181 2 13. The duration of the training programme ranged from eight weeks in a small trial (50 patients) to a year or more in the largest studies 2491014. Mean follow up was from 159 to 2284 days (table 1).…”

Section: Resultsmentioning

confidence: 99%

Exercise training meta-analysis of trials in patients with chronic heart failure (ExTraMATCH)

2004

BMJ

544

118

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Objective To determine the effect of exercise training on survival in patients with heart failure due to left ventricular systolic dysfunction. Design Collaborative meta-analysis. Inclusion criteria Randomised parallel group controlled trials of exercise training for at least eight weeks with individual patient data on survival for at least three months. Studies reviewed Nine datasets, totalling 801 patients: 395 received exercise training and 406 were controls. Main outcome measure Death from all causes. Results During a mean (SD) follow up of 705 (729) days there were 88 (22%) deaths in the exercise arm and 105 (26%) in the control arm. Exercise training significantly reduced mortality (hazard ratio 0.65, 95% confidence interval, 0.46 to 0.92; log rank 2 = 5.9; P = 0.015). The secondary end point of death or admission to hospital was also reduced (0.72, 0.56 to 0.93; log rank 2 = 6.4; P = 0.011). No statistically significant subgroup specific treatment effect was observed. Conclusion Meta-analysis of randomised trials to date gives no evidence that properly supervised medical training programmes for patients with heart failure might be dangerous, and indeed there is clear evidence of an overall reduction in mortality. Further research should focus on optimising exercise programmes and identifying appropriate patient groups to target.

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Section: Resultsmentioning

confidence: 99%

Exercise training meta-analysis of trials in patients with chronic heart failure (ExTraMATCH)

2004

BMJ

544

118

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“…(12–18) However, to our knowledge, there has been no published study of ET in patients with established HFPEF. In 18 patients with dyspnea and Doppler evidence of diastolic dysfunction, Smart et al reported that ET significantly improved peak VO 2 and QOL and to a similar extent as those with systolic dysfunction.…”

Section: Introductionmentioning

confidence: 99%

Exercise Training in Older Patients With Heart Failure and Preserved Ejection Fraction

Kitzman

Brubaker

Morgan

et al. 2010

Circ: Heart Failure

351

350

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Background-Heart failure (HF) with preserved left ventricular ejection fraction (HFPEF) is the most common form of HF in the older population. Exercise intolerance is the primary chronic symptom in patients with HFPEF and is a strong determinant of their reduced quality of life (QOL). Exercise training (ET) improves exercise intolerance and QOL in patients with HF with reduced ejection fraction (EF). However, the effect of ET in HFPEF has not been examined in a randomized controlled trial. Methods and Results-This 16-week investigation was a randomized, attention-controlled, single-blind study of medically supervised ET (3 days per week) on exercise intolerance and QOL in 53 elderly patients (mean age, 70Ϯ6 years; range, 60 to 82 years; women, 46) with isolated HFPEF (EF Ն50% and no significant coronary, valvular, or pulmonary disease). Attention controls received biweekly follow-up telephone calls. Forty-six patients completed the study (24 ET, 22 controls). Attendance at exercise sessions in the ET group was excellent (88%; range, 64% to 100%). There were no trial-related adverse events. The primary outcome of peak exercise oxygen uptake increased significantly in the ET group compared to the control group (13.8Ϯ2.5 to 16.1Ϯ2.6 mL/kg per minute [change, 2.3Ϯ2.2 mL/kg per minute] versus 12.8Ϯ2.6 to 12.5Ϯ3.4 mL/kg per minute [change, Ϫ0.3Ϯ2.1 mL/kg per minute]; Pϭ0.0002). There were significant improvements in peak power output, exercise time, 6-minute walk distance, and ventilatory anaerobic threshold (all PϽ0.002). There was improvement in the physical QOL score (Pϭ0.03) but not in the total score (Pϭ0.11). Conclusions-ET

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“…In addition, exercise training regimens are well established adjuvant therapies for heart failure patients, which reduce symptoms and improve cardiac function,3 4 exercise tolerance, perceived quality of life5 and daily activity levels 4. Despite multiple studies demonstrating clear efficacy and safety of exercise training in heart failure patients, the mechanisms explaining the improvements are not well understood.…”

Section: Introductionmentioning

confidence: 99%

Exercise training in dilated cardiomyopathy improves rest and stress cardiac function without changes in cardiac high energy phosphate metabolism

Holloway

Dass

Suttie

et al. 2012

Heart

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Short-term exercise training improves resting LVEF and LVEF with acute physical exercise with sedentary patients having the greatest improvement. There were no changes in cardiac PCr to ATP, before or after exercise training, suggesting that the improved cardiac function was not caused by improved energetics. Therefore, peripheral factors likely underlie the improved cardiac function in patients with heart failure after short-term exercise.

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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.

Cited by 81 publications

References 0 publications

Exercise training meta-analysis of trials in patients with chronic heart failure (ExTraMATCH)

Exercise training meta-analysis of trials in patients with chronic heart failure (ExTraMATCH)

Exercise Training in Older Patients With Heart Failure and Preserved Ejection Fraction

Exercise training in dilated cardiomyopathy improves rest and stress cardiac function without changes in cardiac high energy phosphate metabolism

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