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Exercise testing and training in heart failure
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Comparison of oxygen uptake during bicycle exercise in patients with chronic heart failure and normal subjects
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Physical training in patients with stable chronic heart failure: Effects on cardiorespiratory fitness and ultrastructural abnormalities of leg muscles
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Hambrecht R, Niebaure J, Fiehn E, Kälberer B, Offner B, Hauer K, et al. Physical training in patients with stable chronic heart failure: effects on cardiorespiratory fitness and ultrastructural abnormalities of leg muscles. J Am Coll Cardiol 1995; 25:1239-1249.
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Keteyian SJ, Levine AB, Brawner CA, Kataoka T, Rogers FJ, Schairer JR, et al. Exercise training in patients with heart failure. A randomized, controlled trial. Ann Intern Med 1996; 124:1051-1057.
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9
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Effect of high intensity exercise training on central hemodynamic responses to exercise in men with reduced left ventricular function
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Dubach P, Myers J, Dziekan G, Goebbels U, Reinhart W, Muller P, et al. Effect of high intensity exercise training on central hemodynamic responses to exercise in men with reduced left ventricular function. J Am Coll Cardiol 1997; 29:1591-1598.
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Randomized, controlled trial of long-term moderate exercise training in chronic heart failure
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Belardinelli R, Georgiou D, Pucaro A. Randomized, controlled trial of long-term moderate exercise training in chronic heart failure. Circulation 1999; 99:1173-1182. • An important trial that not only demonstrated many favorable changes in intermediate markers such as exercise capacity, quality of life and ejection fraction, but was also the first to show a significant impact on mortality and heart failure-related hospitalizations. This study is also one of the longer clinical exercise trials published in the literature, with a total follow-up of 14 months.
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Belardinelli, R.1
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Endothelial dysfunction in patients with chronic heart failure: Systemic effects of lower-limb exercise training
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Linke A, Schoene N, Gielen S, Hofer J, Erbs S, Schuler G, Hambrecht R. Endothelial dysfunction in patients with chronic heart failure: systemic effects of lower-limb exercise training. J Am Coll Cardiol 2001; 37:392-397.
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12
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Effects of exercise training in patients with heart failure: The exercise rehabilitation trial (EXERT)
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McKelvie RS, Teo KK, Roberts R, Tech M, McCartney N, Humen D, et al. Effects of exercise training in patients with heart failure: the exercise rehabilitation trial (EXERT). Am Heart J 2002; 144:23-60. • Excellent trial design comparing a group participating in 3 months of supervised exercise followed by 9 months of home exercise with a non-exercising control group. Adherence to exercise was good during the supervised phase and reduced during home exercise, paralleling the initial improvements in exercise capacity that partially declined by 1 year.
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Am Heart J
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McKelvie, R.S.1
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Antiremodeling effect of long-term exercise training in patients with stable chronic heart failure
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Giannuzzi P, Temporelli PL, Corra U, Tavazzi L. Antiremodeling effect of long-term exercise training in patients with stable chronic heart failure. Circulation 2003; 108:554-559. •• Ninety patients randomized to 6 months of exercising three to five times per week for 30 min or a non-exercise control group. Among the patients in the exercise group, left ventricular end-diastolic volume decreased by 5% and left ventricular end-systolic volume decreased by 7%. Not only did exercise training have no detrimental effect on left ventricular characteristics, but it also induced a very modest anti-remodeling effect.
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Giannuzzi, P.1
Temporelli, P.L.2
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Tavazzi, L.4
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14
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The effects of exercise training on sympathetic neural activation in advanced heart failure
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Roveda F, Middlekauff HR, Rondon MUPB, Reis SF, Souza M, Nastari L, et al. The effects of exercise training on sympathetic neural activation in advanced heart failure. J Am Coll Cardiol 2003; 42:854-860. •• Directly assessed the effects of exercise training on sympathetic neural activation in patients with heart failure, using a training model of 180 min of exercise per week versus sedentary controls. Sympathetic activity was decreased and both exercise capacity and forearm blood flow were increased with training. Landmark trial because it directly measured the effects of regular exercise on sympathetic function, a system known to be overactive and associated with sudden cardiac death.
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J Am Coll Cardiol
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Roveda, F.1
Middlekauff, H.R.2
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Nastari, L.6
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15
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Rehabilitation of patients with congestive heart failure with or without B-blockade therapy
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Curnier D, Galinier M, Pathak A, Fourcade J, Bousquet M, Seward JM, et al. Rehabilitation of patients with congestive heart failure with or without B-blockade therapy. J Cardiac Failure 2001; 7:241-248. • Most all of the earlier exercise trials involving patients with heart failure were completed with the majority of study participants not taking a β-adrenergic blocking agent. This trial showed no difference in improvement in exercise capacity with training when comparing one group taking β-adrenergic blockade (metoprolol, bisoprolol, carvedilol) with an exercise-training group not taking b-blockade.
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J Cardiac Failure
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17
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Effects of exercise training on left ventricular function and peripheral resistance in patients with chronic heart failure
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Hambrecht R, Gielen S, Linke A, Fiehn E, Yu J, Walter C, et al. Effects of exercise training on left ventricular function and peripheral resistance in patients with chronic heart failure. JAMA 2000; 283:3095-3101.
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18
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Effects of exercise training on chronotropic incompetence in patients with heart failure
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Keteyian SJ, Brawner CA, Schairer JR, Levine TB, Levine AB, Rogers FJ, et al. Effects of exercise training on chronotropic incompetence in patients with heart failure. Am Heart J 1999; 138:233-240.
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Regular physical exercise corrects endothelial dysfunction and improves exercise capacity in patients with chronic heart failure
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Hambrecht R, Fiehn E, Weigl C, Gielen S, Hamann C, Kaiser R, et al. Regular physical exercise corrects endothelial dysfunction and improves exercise capacity in patients with chronic heart failure. Circulation 1998; 98:2709-2715.
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Deconditioning fails to explain peripheral skeletal muscle alterations in men with chronic heart failure
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Duscha BD, Annex BH, Green HJ, Pippen AM, Kraus WE. Deconditioning fails to explain peripheral skeletal muscle alterations in men with chronic heart failure. J Am Coll Cardiol 2002; 39:1170-1174.
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Capillary density of skeletal muscle a contributing mechanism for exercise intolerance in class II-III chronic heart failure independent of other peripheral alterations
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Duscha BD, Kraus WE, Keteyian SJ, Sullivan MJ, Green HJ, Schachat FH, et al. Capillary density of skeletal muscle a contributing mechanism for exercise intolerance in class II-III chronic heart failure independent of other peripheral alterations. J Am Coll Cardiol 1999; 33:1956-1963.
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Impaired skeletal muscle function in patients with congestive heart failure: Relationship to systemic exercise performance
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Toth MJ, Gottieb SS, Fisher ML, Poehlman ET. Skeletal muscle atrophy and peak oxygen consumption in heart failure. Am J Cardiol 1997; 79:1267-1269.
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Apoptosis in skeletal myocytes of patients with chronic heart failure is associated with exercise intolerance
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Adams V, Jiang H, Yu J, Möbius-Winkler S, Fiehn E, Linke A, et al. Apoptosis in skeletal myocytes of patients with chronic heart failure is associated with exercise intolerance. J Am Coll Cardiol 1999; 33: 959-965. • Primary finding was that apoptosis occurs in skeletal muscle and is associated with the impaired exercise tolerance that is characteristic of patients with heart failure. Any role that exercise might play in mediating the cellular triggers that regulate skeletal muscle apoptosis is worthy of future investigation.
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J Am Coll Cardiol
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Strength/endurance training versus endurance training in congestive heart failure
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Randomized trial of progressive resistance training to counteract the myopathy of chronic heart failure
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Differential effects of exercise training in men and women with chronic heart failure
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Keteyian SJ, Duscha BD, Brawner CA, Green HJ, Marks CRC, Schachat FH, et al. Differential effects of exercise training in men and women with chronic heart failure. Am Heart J 2003; 145:912-918.
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Keteyian, S.J.1
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29
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Anti-inflammatory effects of exercise training in the skeletal muscle of patients with chronic heart failure
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Gielen S, Adams V, Möbus-Winker S, Linke A, Erbs S, Yu J, et al. Anti-inflammatory effects of exercise training in the skeletal muscle of patients with chronic heart failure. J Am Coll Cardiol 2003; 42:861-868. •• This study assessed the effects of exercise training on local inflammatory parameters in skeletal muscle obtained via biopsy. Results showed marked reductions in each of three inflammatory markers (tumor necrosis factor-α, interleukin-6 and interleukin-1β), suggesting that exercise training may attenuate the catabolic process associated with the progression of heart failure. Further work is needed to determine whether exercise-induced improvements in the expression of inflammation at the tissue level are related to improvements in muscle strength, endurance and histochemistry.
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J Am Coll Cardiol
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LeMaitre JP, Harris S, Fax KAA, Denvir M. Change in circulatory cytokines after 2 terms of exercise training in chronic stable heart failure. Eur Heart J 2004; 147:100-105.
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