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Physical training in patients with chronic heart failure of ischemic origin: effect on exercise capacity and left ventricular remodeling.
Eur J Cardiovasc Prev Rehabil. 2007 Feb; 14(1):85-91.EJ

Abstract

BACKGROUND

Physical training is a well-known complementary treatment for chronic heart failure (CHF); however, many aspects require further studies. One of them is the impact on remodeling of the left ventricle (LV). The purpose of this study was to evaluate the effect of 6 months of training on LV, exercise capacity and safety issues in patients with ischemic CHF.

METHODS

Fifty patients (mean age 60.1+/-9.2 years) with ischemic CHF, New York Heart Association (NYHA) classification class II and III and left ventricular ejection fraction (LVEF) <or=35% were randomized into groups: undergoing 6-month training (25 patients) and not trained (25 patients). In both groups at baseline and at 6 months a cardiopulmonary exercise test and magnetic resonance imaging (MRI) with evaluation of LV were performed. Training was limited by the achievement of 80% of the predicted heart rate at VO2peak achieved at the baseline cardiopulmonary exercise test.

RESULTS

All patients completed the 6-month observation. No serious adverse events were found in either group. Exercise capacity improved only in the trained group (VO2peak increased by 31%). At 6 months in the trained group there was a tendency towards an improvement in some LV parameters: ejection fraction, end-diastolic volume and wall motion score index (WMSI), whereas an opposite trend was seen in the controls (P<0.05, P<0.05 and P<0.01 for comparison of LVEFs, end-diastolic volumes and WMSIs, respectively).

CONCLUSIONS

Six-month training in ischemic CHF patients is a safe modality. Training improves exercise capacity. There was no negative impact on LV morphology, and a trend towards improvement of functional parameters on MRI may suggest an anti-remodeling effect of training in patients with ischemic CHF.

Authors+Show Affiliations

I Cardiac Department, Jagiellonian University Medical College, Kraków, Poland. arturklecha@poczta.onet.plNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17301632

Citation

Klecha, Artur, et al. "Physical Training in Patients With Chronic Heart Failure of Ischemic Origin: Effect On Exercise Capacity and Left Ventricular Remodeling." European Journal of Cardiovascular Prevention and Rehabilitation : Official Journal of the European Society of Cardiology, Working Groups On Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology, vol. 14, no. 1, 2007, pp. 85-91.
Klecha A, Kawecka-Jaszcz K, Bacior B, et al. Physical training in patients with chronic heart failure of ischemic origin: effect on exercise capacity and left ventricular remodeling. Eur J Cardiovasc Prev Rehabil. 2007;14(1):85-91.
Klecha, A., Kawecka-Jaszcz, K., Bacior, B., Kubinyi, A., Pasowicz, M., Klimeczek, P., & Banyś, R. (2007). Physical training in patients with chronic heart failure of ischemic origin: effect on exercise capacity and left ventricular remodeling. European Journal of Cardiovascular Prevention and Rehabilitation : Official Journal of the European Society of Cardiology, Working Groups On Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology, 14(1), 85-91.
Klecha A, et al. Physical Training in Patients With Chronic Heart Failure of Ischemic Origin: Effect On Exercise Capacity and Left Ventricular Remodeling. Eur J Cardiovasc Prev Rehabil. 2007;14(1):85-91. PubMed PMID: 17301632.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Physical training in patients with chronic heart failure of ischemic origin: effect on exercise capacity and left ventricular remodeling. AU - Klecha,Artur, AU - Kawecka-Jaszcz,Kalina, AU - Bacior,Bogumiła, AU - Kubinyi,Aleksandra, AU - Pasowicz,Mieczysław, AU - Klimeczek,Piotr, AU - Banyś,Robert, PY - 2007/2/16/pubmed PY - 2007/5/18/medline PY - 2007/2/16/entrez SP - 85 EP - 91 JF - European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology JO - Eur J Cardiovasc Prev Rehabil VL - 14 IS - 1 N2 - BACKGROUND: Physical training is a well-known complementary treatment for chronic heart failure (CHF); however, many aspects require further studies. One of them is the impact on remodeling of the left ventricle (LV). The purpose of this study was to evaluate the effect of 6 months of training on LV, exercise capacity and safety issues in patients with ischemic CHF. METHODS: Fifty patients (mean age 60.1+/-9.2 years) with ischemic CHF, New York Heart Association (NYHA) classification class II and III and left ventricular ejection fraction (LVEF) <or=35% were randomized into groups: undergoing 6-month training (25 patients) and not trained (25 patients). In both groups at baseline and at 6 months a cardiopulmonary exercise test and magnetic resonance imaging (MRI) with evaluation of LV were performed. Training was limited by the achievement of 80% of the predicted heart rate at VO2peak achieved at the baseline cardiopulmonary exercise test. RESULTS: All patients completed the 6-month observation. No serious adverse events were found in either group. Exercise capacity improved only in the trained group (VO2peak increased by 31%). At 6 months in the trained group there was a tendency towards an improvement in some LV parameters: ejection fraction, end-diastolic volume and wall motion score index (WMSI), whereas an opposite trend was seen in the controls (P<0.05, P<0.05 and P<0.01 for comparison of LVEFs, end-diastolic volumes and WMSIs, respectively). CONCLUSIONS: Six-month training in ischemic CHF patients is a safe modality. Training improves exercise capacity. There was no negative impact on LV morphology, and a trend towards improvement of functional parameters on MRI may suggest an anti-remodeling effect of training in patients with ischemic CHF. SN - 1741-8267 UR - https://www.unboundmedicine.com/medline/citation/17301632/Physical_training_in_patients_with_chronic_heart_failure_of_ischemic_origin:_effect_on_exercise_capacity_and_left_ventricular_remodeling_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=17301632.ui DB - PRIME DP - Unbound Medicine ER -