Fræðigrein

Objective: Supervised cardiac rehabilitation programs have been offered to patients following myocardial infarct (MI), coronary artery bypass graft surgery (CABG) and percutaneous coronary intervention (PCI) for many years. However, limited information is available on the usefulness of rehabilitation programs in chronic heart failure (CHF). The aim of our study was to evalutate the outcome of supervised physical training on CHF patients by measuring both central and peripheral factors.

Material and methods: This was a prospective randomized study, including 43 patients with CHF, New York Heart Association (NYHA) class II or III, mean age 68 years. After initial measurements of V02peak, 6 minute walk distance, muscle strength, plasma levels of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP), echocardiogram, measurements of pulmonary function and quality of life questionnaire, patients were randomized to either a training group (n=21) or a control group (n=22). The training group had supervised aerobic and resistance training program twice a week for five months. After the training program was completed, all measurements were repeated in both groups.

Results: No training related adverse events were reported. Significant improvement was found between groups in the six minute walk test (+37.1 m vs. +5.3 m, p=0.01), work load on the bicycle exercise test (+6.1W vs. +2.1 W, p=0.03), time on the bicycle exercise test (+41 s vs +0 s, p=0.02) and quadriceps muscle strength test (+2.8 kg vs + 0.2 kg, 0.003). Qualtity of life factors that reflect exercise tolerance and general health, improved significantly in the training group compared to the control group. No other significant changes were found between the two groups.

Conclusion: Supervised physical training as used in this study appears safe for CHF patients in NYHA class II or III. The improvement in funcional capacity observed in the training group seems to be related more to increased muscle performance rather than central cardiovascular conditioning.

Keywords: CHF (congestive heart failure), physical training, V02max, Quality of life.

 

Correspondence: Karl Andersen, andersen@landspitali.is

Læknablaðið 2006; 92: 759-64