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Antiremodeling effect of long-term exercise training in patients with stable chronic heart failure: results of the Exercise in Left Ventricular Dysfunction and Chronic Heart Failure (ELVD-CHF) Trial.
Circulation 2003; 108(5):554-9Circ

Abstract

BACKGROUND

The effects of exercise training (ET) on left ventricular (LV) remodeling in chronic heart failure are not definitively established, and the safety of ET in these patients is still debated.

METHODS AND RESULTS

This multicenter study investigated the long-term effect of moderate ET on LV remodeling, work capacity, and quality of life (QoL) in 90 patients with stable chronic heart failure caused by LV systolic dysfunction, randomized to a 6-month ET program (T, n=45) or a control group (C, n=45). All patients underwent resting echocardiography, a cardiopulmonary exercise test, 6-minute walking test, and QoL assessment at entry and after 6 months. At entry, end-diastolic (EDV) and end-systolic (ESV) volume, ejection fraction, work capacity, peak o2, and walking distance were similar in the 2 groups. After 6 months, LV volumes diminished in T (EDV, from 142+/-26 to 135+/-26 mL/m2, P<0.006; ESV, from 107+/-24 to 97+/-24 mL/m2, P<0.05) but increased in C (EDV, from 147+/-41 to 156+/-42 mL/m2, P<0.01; ESV, from 110+/-34 to 118+/-34 mL/m2, P<0.01). Ejection fraction improved in T (P<0.001) but was unchanged in C (P=NS). Significant improvement in work capacity (P<0.001), peak VO2 (P<0.006), walking distance (P<0.001), and QoL (P<0.01) was observed in T but not in C (P=NS). T showed a trend toward fewer (P=0.05) hospital readmissions for worsening dyspnea in the absence of other adverse cardiac events.

CONCLUSIONS

In stable chronic heart failure, long-term moderate ET has no detrimental effect on LV volumes and function; rather, it attenuates abnormal remodeling. Furthermore, ET is safe and effective in improving exercise tolerance and QoL.

Authors+Show Affiliations

Fondazione Salvatore Maugeri, IRCCS, Via Revislate, 13, 28013 Veruno, Italy. pgiannuzzi@fsm.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

12860904

Citation

Giannuzzi, Pantaleo, et al. "Antiremodeling Effect of Long-term Exercise Training in Patients With Stable Chronic Heart Failure: Results of the Exercise in Left Ventricular Dysfunction and Chronic Heart Failure (ELVD-CHF) Trial." Circulation, vol. 108, no. 5, 2003, pp. 554-9.
Giannuzzi P, Temporelli PL, Corrà U, et al. Antiremodeling effect of long-term exercise training in patients with stable chronic heart failure: results of the Exercise in Left Ventricular Dysfunction and Chronic Heart Failure (ELVD-CHF) Trial. Circulation. 2003;108(5):554-9.
Giannuzzi, P., Temporelli, P. L., Corrà, U., & Tavazzi, L. (2003). Antiremodeling effect of long-term exercise training in patients with stable chronic heart failure: results of the Exercise in Left Ventricular Dysfunction and Chronic Heart Failure (ELVD-CHF) Trial. Circulation, 108(5), pp. 554-9.
Giannuzzi P, et al. Antiremodeling Effect of Long-term Exercise Training in Patients With Stable Chronic Heart Failure: Results of the Exercise in Left Ventricular Dysfunction and Chronic Heart Failure (ELVD-CHF) Trial. Circulation. 2003 Aug 5;108(5):554-9. PubMed PMID: 12860904.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antiremodeling effect of long-term exercise training in patients with stable chronic heart failure: results of the Exercise in Left Ventricular Dysfunction and Chronic Heart Failure (ELVD-CHF) Trial. AU - Giannuzzi,Pantaleo, AU - Temporelli,Pier Luigi, AU - Corrà,Ugo, AU - Tavazzi,Luigi, AU - ,, Y1 - 2003/07/14/ PY - 2003/7/16/pubmed PY - 2003/9/16/medline PY - 2003/7/16/entrez SP - 554 EP - 9 JF - Circulation JO - Circulation VL - 108 IS - 5 N2 - BACKGROUND: The effects of exercise training (ET) on left ventricular (LV) remodeling in chronic heart failure are not definitively established, and the safety of ET in these patients is still debated. METHODS AND RESULTS: This multicenter study investigated the long-term effect of moderate ET on LV remodeling, work capacity, and quality of life (QoL) in 90 patients with stable chronic heart failure caused by LV systolic dysfunction, randomized to a 6-month ET program (T, n=45) or a control group (C, n=45). All patients underwent resting echocardiography, a cardiopulmonary exercise test, 6-minute walking test, and QoL assessment at entry and after 6 months. At entry, end-diastolic (EDV) and end-systolic (ESV) volume, ejection fraction, work capacity, peak o2, and walking distance were similar in the 2 groups. After 6 months, LV volumes diminished in T (EDV, from 142+/-26 to 135+/-26 mL/m2, P<0.006; ESV, from 107+/-24 to 97+/-24 mL/m2, P<0.05) but increased in C (EDV, from 147+/-41 to 156+/-42 mL/m2, P<0.01; ESV, from 110+/-34 to 118+/-34 mL/m2, P<0.01). Ejection fraction improved in T (P<0.001) but was unchanged in C (P=NS). Significant improvement in work capacity (P<0.001), peak VO2 (P<0.006), walking distance (P<0.001), and QoL (P<0.01) was observed in T but not in C (P=NS). T showed a trend toward fewer (P=0.05) hospital readmissions for worsening dyspnea in the absence of other adverse cardiac events. CONCLUSIONS: In stable chronic heart failure, long-term moderate ET has no detrimental effect on LV volumes and function; rather, it attenuates abnormal remodeling. Furthermore, ET is safe and effective in improving exercise tolerance and QoL. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/12860904/Antiremodeling_effect_of_long_term_exercise_training_in_patients_with_stable_chronic_heart_failure:_results_of_the_Exercise_in_Left_Ventricular_Dysfunction_and_Chronic_Heart_Failure__ELVD_CHF__Trial_ L2 - http://www.ahajournals.org/doi/full/10.1161/01.CIR.0000081780.38477.FA?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -