Beneficial Effects of Exercise Training in Patients with Chronic Heart Failure
DOI:
https://doi.org/10.12970/2311-052X.2013.01.01.5Keywords:
Heart Failure, exercise training, functional capacityAbstract
Several human and experimental studies have been performed to show the effects of exercise training on chronic heart failure (CHF). These studies have shown that exercise improves the adverse pathophysiologic changes which occur with CHF, including enhanced exercise capacity, ventilation, skeletal muscle metabolism, cardiac function, quality of life, and peripheral blood flow. In addition, there is an improved modulation of inflammatory, autonomic, and hormonal dysregulation after exercise training. This review focuses on the current evidence surrounding the beneficial effects of exercise training in CHF patients.
References
McDonald CD, Burch GE, Walsh JJ. Prolonged bed rest in the treatment of idiopathic cardiomyopathy. Am J Med 1972; 52: 41-50. http://dx.doi.org/10.1016/0002-9343(72)90006-X
Sullivan MJ, Higginbotham MB, Cobb FR. Exercise training in patients with severe left ventricular dysfunction: hemodynamic and metabolic effects. Circulation 1988; 78: 506-15. http://dx.doi.org/10.1161/01.CIR.78.3.506
Coats AJS, Adamopoulos S, Meyer TE, Conway J, Sleight P. Effects of physical training in chronic heart failure. Lancet 1990; 335: 63-6. http://dx.doi.org/10.1016/0140-6736(90)90536-E
Smith AA, Cowburn PJ, Parker ME, et al. Impaired pulmonary diffusion during exercise in patients with chronic heart failure. Circulation 1999; 100: 1406-10. http://dx.doi.org/10.1161/01.CIR.100.13.1406
Seigel JL, Miller A, Brown LK, DeLuca A, Tierstein AJ. Pulmonary diffusing capacity in left ventricular failure. Chest 1990; 98: 550-3. http://dx.doi.org/10.1378/chest.98.3.550
Messner-Pellenc P, Brasileiro C, Ahmaidi S, et al. Exercise intolerance in patients with chronic heart failure: role of pulmonary diffusion limitation. Eur Heart J 1995; 16: 201-9.
Puri S, Baker BL, Dutka DP, Oakley CM, Hughes JMB, Cleland JGF. Reduced alveolar-capillary membrane diffusing capacity in chronic heart failure: its pathophysiological relevance and relationship to exercise performance. Circulation 1995; 91: 2769-74. http://dx.doi.org/10.1161/01.CIR.91.11.2769
Tikunov B, Levine S, Mancini D. Chronic congestive heart failure elicits adaptation of endurance exercise in diaphragmatic muscle. Circulation 1997; 95: 910-6. http://dx.doi.org/10.1161/01.CIR.95.4.910
Buller NP, Poole-Wilson PA. Mechanism of the increased ventilatory response to exercise in patients with chronic heart failure. Br Heart J 1990; 63: 281-3. http://dx.doi.org/10.1136/hrt.63.5.281
Sullivan MJ, Higginbotham MB, Cobb FR. Increased exercise ventilation in patients with chronic heart failure: Intact ventilatory control despite hemodynamic and pulmonary abnormalities. Circulation 1988; 77: 552-9. http://dx.doi.org/10.1161/01.CIR.77.3.552
Massie BM, Conway M, Rajagopalan B, et al. Skeletal muscle metabolism during exercise under ischemic conditions in congestive heart failure. Evidence for abnormalities unrelated to blood flow. Circulation 1988; 78: 320-6. http://dx.doi.org/10.1161/01.CIR.78.2.320
Massie BM, Conway M, Yonge R, et al. 31P nuclear magnetic resonance evidence of abnormal skeletal muscle metabolism in patients with congestive heart failure. Am J Cardiol 1987; 60: 309-15. http://dx.doi.org/10.1016/0002-9149(87)90233-5
Wiener DH, Fink LI, Maris J, Jones RA, Chance B, Wilson JR. Abnormal skeletal muscle bioenergetics during exercise in patients with heart failure: Role of reduced muscle flow. Circulation 1986; 73: 1127-36. http://dx.doi.org/10.1161/01.CIR.73.6.1127
Massie B, Conway M, Yonge R, et al. Skeletal muscle metabolism in patients with congestive heart failure: relation to clinical severity and blood flow. Circulation 1987; 76: 1009-19. http://dx.doi.org/10.1161/01.CIR.76.5.1009
Wilson JR, Fink L, Maris J, et al. Evaluation of energy metabolism in skeletal muscle of patients with heart failure with gated phosphorous-31 nuclear magnetic resonance. Circulation 1985; 71: 57-62. http://dx.doi.org/10.1161/01.CIR.71.1.57
Lipkin DP, Jones DA, Round JM, Poole-Wilson PA. Abnormalities of skeletal muscle in patients with chronic heart failure. Int J Cardiol 1988; 18: 187-95. http://dx.doi.org/10.1016/0167-5273(88)90164-7
Sullivan MJ, Green HJ, Cobb FR. Skeletal muscle biochemistry and histology in ambulatory patients with long-term heart failure. Circulation 1990; 81: 518-27. http://dx.doi.org/10.1161/01.CIR.81.2.518
Drexler H, Riede U, Münzel T, König H, Funke E, Just H. Alterations of skeletal muscle in chronic heart failure. Circulation 1992; 85: 1751-9. http://dx.doi.org/10.1161/01.CIR.85.5.1751
Sullivan MJ, Duscha BD, Klitgaard H, Kraus WE, Cobb FR, Saltin B. Altered expression of myosin heavy chain in human skeletal muscle in chronic heart failure. Med Sci Sports Exerc 1997; 29: 860-6. http://dx.doi.org/10.1097/00005768-199707000-00004
Mancini DM, Coyle E, Coggan A, et al. Contribution of intrinsic skeletal muscle changes to 31P NMR skeletal muscle metabolic abnormalities in patients with chronic heart failure. Circulation 1989; 80: 1338-46. http://dx.doi.org/10.1161/01.CIR.80.5.1338
Adams V, Jiang H, Yu J, et al. Apoptosis in skeletal myocytes of patients with chronic heart failure is associated with exercise intolerance. J Am Coll Cordial 1999; 33: 959-65. http://dx.doi.org/10.1016/S0735-1097(98)00626-3
Piepoli MF, Kaczmarek A, Francis DP, et al. Reduced peripheral skeletal muscle mass and abnormal reflex physiology in chronic heart failure. Circulation 2006; 114: 126-34. http://dx.doi.org/10.1161/CIRCULATIONAHA.105.605980
Wilson JR, Martin JL, Schwartz D, Ferraro N. Exercise intolerance in patients with chronic heart failure: role of impaired nutritive flow to skeletal muscle. Circulation 1984; 69: 1079-87. http://dx.doi.org/10.1161/01.CIR.69.6.1079
Duscha BD, Kraus WE, Keteyian SJ, 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 Cordial 1999; 33: 1956-63. http://dx.doi.org/10.1016/S0735-1097(99)00101-1
Mancini D, Walter G, Reicheck N, et al. Contribution of skeletal muscle atrophy to exercise intolerance and altered muscle metabolism in heart failure. Circulation 1992; 85: 1364-73. http://dx.doi.org/10.1161/01.CIR.85.4.1364
Olson TP, Snyder EM, Johnson BD. Exercise-disordered breathing in chronic heart failure. Exerc Sport Sci Rev 2006; 34: 194-201. http://dx.doi.org/10.1249/01.jes.0000240022.30373.a2
Belardinelli R, Georgiou D, Cianci G, Berman N, Ginzton L, Purcaro A. Exercise training improves left ventricular diastolic filling in patients with dilated cardiomyopathy: clinical and prognostic implications. Circulation 1995; 91: 2775-84. http://dx.doi.org/10.1161/01.CIR.91.11.2775
Keteyian SJ, Levine AB, Brawner CA, et al. Exercise training in patients with heart failure: a randomized, controlled trial. Ann Int Med 1996; 124: 1051-7. http://dx.doi.org/10.7326/0003-4819-124-12-199606150-00004
Jetté M, Heller R, Landry F, Blümchen G. Randomized 4-week exercise program in patients with impaired left ventricular function. Circulation 1991; 84: 1561-7. http://dx.doi.org/10.1161/01.CIR.84.4.1561
Belardinelli R, Scocco V, Mazzanti M, Purcaro A. Effects of aerobic training in patients with moderate chronic heart failure. G Ital Cardiol 1992; 22: 919-30.
Dubach P, Myers J, Dziekan G, et al. The effect of high intensity exercise training on central hemodynamic response to exercise in men with reduced left ventricular function. J Am Coll Cardiol 1997; 29: 1591-8. http://dx.doi.org/10.1016/S0735-1097(97)82540-5
Hambrecht R, Niebauer J, Fiehn E, 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: 1239-49. http://dx.doi.org/10.1016/0735-1097(94)00568-B
Coats AJ, Adamopoulos S, Radaelli A, et al. Controlled trial of physical training in chronic heart failure: exercise performance, hemodynamics, ventilation, and autonomic function. Circulation 1992; 85: 2119-31. http://dx.doi.org/10.1161/01.CIR.85.6.2119
Radaelli A, Coats AJ, Leuzzi S, et al. Physical training enhances sympathetic and parasympathetic control of heart rate and peripheral vessels in chronic heart failure. Clin Sci (Lond) 1996; 91: 92-4.
Belardinelli R, Georgiou D, Cianci G, Purcaro A. Randomized, controlled trial of long-term moderate exercise training in chronic heart failure: effects on functional capacity, quality of life, and clinical outcome. Circulation 1999; 99: 1173-82. http://dx.doi.org/10.1161/01.CIR.99.9.1173
Callaerts-Végh Z, Wenk M, Goebbels U, et al. Influence of intensive physical training on urinary nitrate elimination and plasma endothelin-1 levels in patients with congestive heart failure. J Cardiopulm Rehabil 1998; 18: 450-7. http://dx.doi.org/10.1097/00008483-199811000-00008
Taylor A. Physiological response to a short period of exercise training in patients with chronic heart failure. Physiother Res Int 1999; 4: 237-49. http://dx.doi.org/10.1002/pri.171
Keteyian SJ, Brawner CA, Schairer JR, et al. Effects of exercise training on chronotropic incompetence in patients with heart failure. Am Heart J 1999; 138(2 Pt 1): 233-40. http://dx.doi.org/10.1016/S0002-8703(99)70106-7
Reinhart WH, Dziekan G, Goebbels U, Myers J, Dubach P. Influence of exercise training on blood viscosity in patients with coronary artery disease and impaired left ventricular function. Am Heart J 1998; 135: 379-82. http://dx.doi.org/10.1016/S0002-8703(98)70311-4
Tyni-Lenné R, Gordon A, Jansson E, Bermann G, Sylvén C. Skeletal muscle endurance training improves peripheral oxidative capacity, exercise tolerance, and health-related quality of life in women with chronic congestive heart failure secondary to either ischemic cardiomyopathy or idiopathic dilated cardiomyopathy. Am J Cardiol 1997; 80: 1025-9. http://dx.doi.org/10.1016/S0002-9149(97)00597-3
Sturm B, Quittan M, Wiesinger GF, Stanek B, Frey B, Pacher R. Moderate-intensity exercise training with elements of step aerobics in patients with severe chronic heart failure. Arch Phys Med Rehabil 1999; 80: 746-50. http://dx.doi.org/10.1016/S0003-9993(99)90221-6
Maiorana A, O'Driscoll G, Cheetham C, et al. Combined aerobic and resistance exercise training improves functional capacity and strength in CHF. J Appl Physiol 2000; 88: 1565-70.
Giannuzzi P, Temporelli PL, Corrà U, Tavazzi L; ELVD-CHF Study Group. Anti-remodeling effect of long-term exercise training in patients with stable chronic heart failure. Circulation 2003; 108: 554-9. http://dx.doi.org/10.1161/01.CIR.0000081780.38477.FA
Myers J, Wagner D, Schertler T, et al. Effects of exercise training on left ventricular volumes and function in patients with non ischemic cardiomyopathy: application of magnetic resonance myocardial tagging. Am Heart J 2002; 144: 719-25.
Belardinelli R, Georgiou D, Scocco V, Barstow TJ, Purcaro A. Low intensity exercise training in patients with chronic heart failure. J Am Call Cardiol 1995; 26: 975-82. http://dx.doi.org/10.1016/0735-1097(95)00267-1
Roveda F, Middlekauff HR, Rondon MU, et al. The effects of exercise training on sympathetic neural activation in advanced heart failure. J Am Coll Cardiol 2003; 42: 854-60. http://dx.doi.org/10.1016/S0735-1097(03)00831-3
Hambrecht R, Gielen S, Linke A, et al. Effects of exercise training on left ventricular function and peripheral resistance in patients with chronic heart failure: a randomized trial. JAMA 2000; 283: 3095-101. http://dx.doi.org/10.1001/jama.283.23.3095
Gielen S, Adams V, Möbius-Winkler S, et al. Anti-inflammatory effects of exercise training in the skeletal muscle of patients with chronic heart failure. J Am Coll Cardiol 2003; 42: 861-8. http://dx.doi.org/10.1016/S0735-1097(03)00848-9
Forissier JF, Vernochet P, Bertrand P, Charbonnier B, Monpère C. Influence of carvedilol on benefits of physical training in patients with moderate chronic heart failure. Eur J Heart Fail 2001; 3: 335-42. http://dx.doi.org/10.1016/S1388-9842(00)00152-5
Linke A, Schoene N, Gielen S, et al. Endothelial dysfunction in patients with chronic heart failure: systemic effects of lower limb exercise training. J Am Coll Cardiol 2001; 37: 392-7. http://dx.doi.org/10.1016/S0735-1097(00)01108-6
Curnier D, Galinier M, Pathak A, et al. Rehabilitation of patients with congestive heart failure with or without beta-blockade therapy. J Card Fail 2001; 7: 241-8. http://dx.doi.org/10.1054/jcaf.2001.26565
Wisloff U, Stoylen A, Loennechen JP, et al. Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients a randomized study. Circulation 2007; 115: 3086-94. http://dx.doi.org/10.1161/CIRCULATIONAHA.106.675041
Beckers PJ, Denollet J, Possemiers NM, Wuyts FL, Vrints CJ, Conraads VM. Combined endurance-resistance training vs. endurance training in patients with chronic heart failure: a prospective randomized study. Eur Heart J 2008; 29: 1858-66. http://dx.doi.org/10.1093/eurheartj/ehn222
Tabet JY, Meurin P, Beauvais F, et al. Absence of exercise capacity improvement after exercise training program a strong prognostic factor in patients with chronic heart failure. Circ Heart Fail 2008; 1: 220-6. http://dx.doi.org/10.1161/CIRCHEARTFAILURE.108.775460
Braith RW, Welsch MA, Feigenbaum MS, Kluess HA, Pepine CJ. Neuroendocrine activation in heart failure is modified by endurance exercise training. J Am Coil Cardiol 1999; 34: 1170-5. http://dx.doi.org/10.1016/S0735-1097(99)00339-3
Feiereisen P, Delagardelle C, Vaillant M, Lasar Y, Beissel J. Is strength training the more efficient training modality in chronic heart failure? Med Sci Sports Exerc 2007; 39: 1910-7. http://dx.doi.org/10.1249/mss.0b013e31814fb545
Smart N, Marwick TH. Exercise training for patients with heart failure: a systematic review of factors that improve mortality and morbidity. Am J Med 2004; 116: 693-706. http://dx.doi.org/10.1016/j.amjmed.2003.11.033
Mancini D, LeJemtel T, Aaronson K. Peak VO2: a simple yet enduring standard. Circulation 2000; 101: 1080-2. http://dx.doi.org/10.1161/01.CIR.101.10.1080
O'Connor CM, Whellan DJ, Lee KL, et al; HF-ACTION Investigators. Efficacy and safety of exercise training in patients with chronic heart failure: HF-ACTION randomized controlled trial. JAMA 2009; 301: 1439-50. http://dx.doi.org/10.1001/jama.2009.454
Dall'Ago P, Chiappa GR, Guths H, Stein R, Ribeiro JP. Inspiratory muscle training in patients with heart failure and inspiratory muscle weakness: a randomized trial. J Am Coll Cardiol 2006; 47: 757-63. http://dx.doi.org/10.1016/j.jacc.2005.09.052
Jankowska EA, Wegrzynowska K, Superlak M, et al. The 12-week progressive quadriceps resistance training improves muscle strength, exercise capacity and quality of life in patients with stable chronic heart failure. Int J Cardiol 2008; 130: 36-43. http://dx.doi.org/10.1016/j.ijcard.2007.07.158
Tenenbaum A, Freimark D, Ahron E, et al. Long-term versus intermediate-term supervised exercise training in advanced heart failure: effects on exercise tolerance and mortality. Int J Cardiol 2006; 113: 364-70. http://dx.doi.org/10.1016/j.ijcard.2005.11.098
Parnell MM, Holst DP, Kaye DM. Exercise training increases arterial compliance in patients with congestive heart failure. Clin Sci (Lond) 2002; 102: 1-7. http://dx.doi.org/10.1042/CS20010107
Arad M, Adler Y, Koren-Morag N, et al. Exercise training in advanced heart failure patients: discordance between improved exercise tolerance and unchanged NT-proBNP levels. Int J Cardiol 2008; 126: 114-9. http://dx.doi.org/10.1016/j.ijcard.2007.05.005
Kiilavuori K, Näveri H, Leinonen H, Härkönen M. The effect of physical training on hormonal status and exertional hormonal response in patients with chronic congestive heart failure. Eur Heart J 1999; 20: 456-64. http://dx.doi.org/10.1053/euhj.1998.1277
Stratton JR, Dunn JF, Adamopoulos S, Kemp GJ, Coats AJ, Rajagopalan B. Training partially reverses skeletal muscle metabolic abnormalities during exercise in heart failure. J Appl Physiol 1994; 76: 1575-82.
Patwala AY, Woods PR, Sharp L, Goldspink DF, Tan LB, Wright DJ. Maximizing patient benefit from cardiac resynchronization therapy with the addition of structured exercise training: a randomized controlled study. J Am Coll Cardiol 2009; 53: 2332-9. http://dx.doi.org/10.1016/j.jacc.2009.02.063
Flynn KE, Piña IL, Whellan DJ, et al; HF-ACTION Investigators. Effects of exercise training on health status in patients with chronic heart failure. HF-ACTION randomized controlled trial. JAMA 2009; 301: 1451-9. http://dx.doi.org/10.1001/jama.2009.457
Walsh JT, Andrews R, Johnson P, Phillips L, Cowley AJ, Kinnear WJ. Inspiratory muscle endurance in patients with chronic heart failure. Heart 1996; 76: 332-6. http://dx.doi.org/10.1136/hrt.76.4.332
Meyer K, Schwaibold M, Westbrook S, et al. Effects of short-term exercise training and activity restriction on functional capacity in patients with severe chronic congestive heart failure. Am J Cardiol 1996; 78: 1017-22. http://dx.doi.org/10.1016/S0002-9149(96)00527-9
Fraga R, Franco FG, Roveda F, et al. Exercise training reduces sympathetic nerve activity in heart failure patients treated with carvedilol. Eur J Heart Fail 2007; 9: 630-6. http://dx.doi.org/10.1016/j.ejheart.2007.03.003
Gademan MG, Swenne CA, Verwey HF, et al. Exercise training increases oxygen uptake efficiency slope in chronic heart failure. Eur J Cardiovasc Prev Rehabil 2008; 15: 140-4. http://dx.doi.org/10.1097/HJR.0b013e3282ef19986
Davey P, Meyer T, Coats A, et al. Ventilation in chronic heart failure: effects of physical training. Br Heart J 1992; 68: 473-7. http://dx.doi.org/10.1136/hrt.68.11.473
Guazzi M, Reina G, Tumminello G, Guazzi MD. Improvement of alveolar-capillary membrane diffusing capacity with exercise training in chronic heart failure. J Appl Physiol 2004; 97: 1866-73. http://dx.doi.org/10.1152/japplphysiol.00365.2004
Francis DP, Shamim W, Ceri Davies L, et al. Cardiopulmonary exercise testing for prognosis in chronic heart failure: continuous and independent prognostic value from VE/VCO2 slope and peak VO2. Eur Heart J 2000; 21: 154-61. http://dx.doi.org/10.1053/euhj.1999.1863
Santoro C, Cosmas A, Forman D, et al. Exercise training alters skeletal muscle mitochondrial morphometry in heart failure patients. J Cardiovasc Risk 2002; 9: 377-81. http://dx.doi.org/10.1097/00043798-200212000-00012
Jakovljevic DG, Donovan G, Nunan D, et al. The effect of aerobic versus resistance exercise training on peak cardiac power output and physical functional capacity in patients with chronic heart failure. Int J Cardiol 2010; 145: 526-8. http://dx.doi.org/10.1016/j.ijcard.2010.04.060
Smart N. Effects of exercise training on functional capacity, quality of life, cytokine and brain natriuretic peptide levels in heart failure patients. J Med & Bio Sci 2008; 2: 1.
Sullivan MJ, Cobb FR. Central hemodynamic response to exercise in patients with chronic heart failure. Chest 1992; 101(5 suppl): 340S-6S. http://dx.doi.org/10.1378/chest.101.5.340S
Hakki A-H, Weinreich DJ, DePace NL, Iskandarian AS. Correlation between exercise capacity and left ventricular function in patients with severely depressed left ventricular function. J Cardiac Rehabil 1984; 4: 38-43.
Lu L, Mei DF, Gu AG, et al. Exercise training normalizes altered calcium-handling proteins during development of heart failure. J Appl Physiol 2002; 92: 1524-30.
Rolim NP, Medeiros A, Rosa KT, et al. Exercise training improves the net balance of cardiac Ca2+ handling protein expression in heart failure. Physiol Genomics 2007; 29: 246-52. http://dx.doi.org/10.1152/physiolgenomics.00188.2006
de Waard MC, van der Velden J, Bito V, et al. Early exercise training normalizes myofilament function and attenuates left ventricular pump dysfunction in mice with a large myocardial infarction. Circ Res 2007; 100: 1079-88. http://dx.doi.org/10.1161/01.RES.0000262655.16373.37
Medeiros A, Rolim NP, Oliveira RS, et al. Exercise training delays cardiac dysfunction and prevents calcium handling abnormalities in sympathetic hyperactivity-induced heart failure mice. J Appl Physiol 2008; 104: 103-9. http://dx.doi.org/10.1152/japplphysiol.00493.2007
Haykowsky MJ, Liang Y, Pechter D, Jones LW, McAlister FA, Clark AM. A meta-analysis of the effect of exercise training on left ventricular remodeling in heart failure patients: the benefit depends on the type of training performed. J Am Coll Cardiol 2007; 49: 2329-36. http://dx.doi.org/10.1016/j.jacc.2007.02.055
van Tol BA, Huijsmans RJ, Kroon DW, Schothorst M, Kwakkel G. Effects of exercise training on cardiac performance, exercise capacity and quality of life in patients with heart failure: a meta-analysis. Eur J Heart Fail 2006; 8: 841-50. http://dx.doi.org/10.1016/j.ejheart.2006.02.013
Adams BJ, Carr JG, Ozonoff A, Lauer MS, Balady GJ. Effect of exercise training in supervised cardiac rehabilitation programs on prognostic variables from the exercise tolerance test. Am J Cardiol 2008; 101: 1403-7. http://dx.doi.org/10.1016/j.amjcard.2008.01.016
Passino C, Severino S, Poletti R, et al. Aerobic training decreases B-type natriuretic peptide expression and adrenergic activation in patients with heart failure. J Am Coll Cardiol 2006; 47: 1835-9. http://dx.doi.org/10.1016/j.jacc.2005.12.050
Demopoulos L, Bijou R, Fergus I, Jones M, Strom J, LeJemtel TH. Exercise training in patients with severe congestive heart failure: enhancing peak aerobic capacity while minimizing the increase in ventricular wall stress. J Am Coll Cardiol 1997; 29: 597-603. http://dx.doi.org/10.1016/S0735-1097(96)00526-8
Belardinelli R, Georgiou D, Cianci G, Purcaro A. Effects of exercise training on left ventricular filling at rest and dur ing exercise in patients with ischemic cardiomyopathy and severe left ventricular systolic dysfunction. Am Heart J 1996; 132: 61-70. http://dx.doi.org/10.1016/S0002-8703(96)90391-9
Malfatto G, Branzi G, Osculati G, et al. Improvement in left ventricular diastolic stiffness induced by physical training in patients with dilated cardiomyopathy. J Card Fail 2009; 15: 327-33. http://dx.doi.org/10.1016/j.cardfail.2008.10.032
Harrington D, Anker S, Chua T, et al. Skeletal muscle function and its relation to exercise tolerance in chronic heart failure. J Am Coll Cardiol 1997; 30: 1758-64. http://dx.doi.org/10.1016/S0735-1097(97)00381-1
Zelis R, Mason DT, Braunwald E. A comparison of the effects of vasodilator stimuli on peripheral resistance vessels in normal subjects and in patients with congestive heart failure. J Clin Invest 1968; 47: 960-70. http://dx.doi.org/10.1172/JCI105788
Zelis R, Longhurst J, Capone RJ, Mason DT. A comparison of regional blood flow and oxygen utilization during dynamic forearm exercise in normal subjects and patients with congestive heart failure. Circulation 1974; 50: 137-43. http://dx.doi.org/10.1161/01.CIR.50.1.137
Zelis R, Flaim SF. Alterations in vasomotor tone in congestive heart failure. Prog Cardiovasc Dis 1982; 24: 437-59. http://dx.doi.org/10.1016/0033-0620(82)90012-3
Levinger I, Bronks R, Cody DV, Linton I, Davie A. Resistance training for chronic heart failure patients on beta blocker medications. Int J Cardiol 2005; 102: 493-9. http://dx.doi.org/10.1016/j.ijcard.2004.05.061
Hare DL, Ryan TM, Selig SE, Pellizzer AM, Wrigley TV, Krum H. Resistance exercise training increases muscle strength, endurance, and blood flow in patients with chronic heart failure. Am J Cardiol 1999; 83: 1674-7. http://dx.doi.org/10.1016/S0002-9149(99)00179-4
Adamopoulos S, Coats AJ, Brunotte F, et al. Physical training improves skeletal muscle metabolism in patients with chronic heart failure. J Am Coll Cardiol 1993; 21: 1101-6. http://dx.doi.org/10.1016/0735-1097(93)90231-O
Magnusson G, Gordon A, Kaijser L, et al. High intensity knee extensor training, in patients with chronic heart failure. Major skeletal muscle improvement. Eur Heart J 1996; 17: 1048-55. http://dx.doi.org/10.1093/oxfordjournals.eurheartj.a015001
Hambrecht R, Fiehn E, Yu J, et al. Effects of endurance training on mitochondrial ultrastructure and fiber type distribution in skeletal muscle of patients with stable chronic heart failure. J Am Coll Cardiol 1997; 29: 1067-73. http://dx.doi.org/10.1016/S0735-1097(97)00015-6
Larsen AI, Lindal S, Aukrust P, Toft I, Aarsland T, Dickstein K. Effect of exercise training on skeletal muscle fibre characteristics in men with chronic heart failure. Correlation between skeletal muscle alterations, cytokines and exercise capacity. Int J Cardiol 2002; 83: 25-32. http://dx.doi.org/10.1016/S0167-5273(02)00014-1
Santos JM, Kowatsch I, Tsutsui JM, et al. Effects of exercise training on myocardial blood flow reserve in patients with heart failure and left ventricular systolic dysfunction. Am J Cardiol 2010; 105: 243-8. http://dx.doi.org/10.1016/j.amjcard.2009.09.009
Van Craenenbroeck EM, Beckers PJ, Possemiers NM, et al. Exercise acutely reverses dysfunction of circulating angiogenic cells in chronic heart failure. Eur Heart J 2010; 31: 1924-34. http://dx.doi.org/10.1093/eurheartj/ehq058
Pietilä M, Malminiemi K, Vesalainen R, et al. Exercise training in chronic heart failure: beneficial effects on cardiac (11)ChydroxyephedrinePET, autonomic nervous control, and ventricular repolarization. J Nucl Med 2002; 43: 773-9.
Hambrecht R, Fiehn E, Weigl C, et al. Regular physical exercise corrects endothelial dysfunction and improves exercise capacity in patients with chronic heart failure. Circulation 1998; 98: 2709-15. http://dx.doi.org/10.1161/01.CIR.98.24.2709
Hornig B, Maier V, Drexler H. Physical training improves endothelial functioning in patients with chronic heart failure. Circulation 1996; 93: 210-4. http://dx.doi.org/10.1161/01.CIR.93.2.210
Wang J, Yi GH, Knecht M, et al. Physical training alters the pathogenesis of pacing-induced heart failure through endothelium- mediated mechanisms in awake dogs. Circulation 1997; 96: 2683-92. http://dx.doi.org/10.1161/01.CIR.96.8.2683
Scarpelli M, Belardinelli R, Tulli D, Provinciali L. Quantitative analysis of changes occurring in muscle vastus lateral is in patients with heart failure after low-intensity training. Anal Quant Cytol Histol 1999; 21: 374-80.
Benedict CR, Johnstone DE, Weiner DH, et al. Relation of neurohumoral activation to clinical variables and degree of ventricular dysfunction: a report from the Registry of Studies of Left Ventricular Dysfunction. SOLVD Investigators. J Am Coll Cardiol 1994; 23: 1410-20. http://dx.doi.org/10.1016/0735-1097(94)90385-9
Anand IS, Fisher LD, Chiang YT, et al. Val-HeFT Investigators. Changes in brain natriuretic peptide and norepinephrine over time and mortality and morbidity in the Valsartan Heart Failure Trial (Val-HeFT). Circulation 2003; 107: 1278-83. http://dx.doi.org/10.1161/01.CIR.0000054164.99881.00
Azevedo ER, Newton GE, Floras JS, Parker JD. Reducing cardiac filling pressure lowers norepinephrine spillover in patients with chronic heart failure. Circulation 2000; 101: 2053-9. http://dx.doi.org/10.1161/01.CIR.101.17.2053
Ferrara R, Mastrorilli F, Pasanisi G, et al. Neurohormonal modulation in chronic heart failure. Eur Heart J Suppl 2002; 4(Suppl D): D3-11. http://dx.doi.org/10.1016/S1520-765X(02)90154-9
Ferguson DW, Berg WJ, Roach PJ, Oren RM, Mark AL. Effects of heart failure on baroreflex control of sympathetic neural activity. Am J Cardiol 1992; 69: 523-31. http://dx.doi.org/10.1016/0002-9149(92)90998-E
Nolan J, Flapan AD, Capewell S, MacDonald TM, Neilson JMM, Ewing DJ. Decreased cardiac parasympathetic activity in chronic heart failure and its relation to left ventricular function. Br Heart J 1992; 67: 482-5. http://dx.doi.org/10.1136/hrt.67.6.482
Ponikowski P, Anker SD, Chua TP, et al. Depressed heart rate variability as an independent predictor of death in chronic congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy. Am J Cardiol 1997; 79: 1645-50. http://dx.doi.org/10.1016/S0002-9149(97)00215-4
Mousa TM, Liu D, Cornish KG, Zucker IH. Exercise training enhances baroreflex sensitivity by an angiotensin II-dependent mechanism in chronic heart failure. J Appl Physiol 2008; 104: 616-24. http://dx.doi.org/10.1152/japplphysiol.00601.2007
Liu JL, Irvine S, Reid IA, Patel KP, Zucker IH. Chronic exercise reduces sympathetic nerve activity in rabbits with pacing induced heart failure: A role for angiotensin II. Circulation 2000; 102: 1854-62. http://dx.doi.org/10.1161/01.CIR.102.15.1854
Liu JL, Kulakofsky J, Zucker IH. Exercise training enhances baroreflex control of heart rate by a vagal mechanism in rabbits with heart failure. J Appl Physiol 2002; 92: 2403-8.
Pliquett RU, Cornish KG, Patel KP, Schultz HD, Peuler JD, Zucker IH. Amelioration of depressed cardiopulmonary reflex control of sympathetic nerve activity by short-term exercise training in male rabbits with heart failure. J Appl Physiol 2003; 95: 1883-8.
Li Y-L, Ding Y, Agnew C, Schultz HD. Exercise training improves peripheral chemoreflex function in heart failure rabbits. J Appl Physiol 2008; 105: 782-90. http://dx.doi.org/10.1152/japplphysiol.90533.2008
Gordon A, Tyni-Lenné R, Jansson E, Kaijser L, Theodorsson-Norheim E, Sylvén C. Improved ventilation and decreased sympathetic stress in chronic heart failure patients following local endurance training with leg muscles. J Card Fail 1997; 3: 3-12. http://dx.doi.org/10.1016/S1071-9164(97)90002-6
Tyni-Lenné R, Dencker K, Gordon A, Jansson E, Sylvén C. Comprehensive local muscle training increases aerobic working capacity and quality of life and decreases neurohormonal activation in patients with chronic heart failure. Eur J Heart Fail 2001; 3: 47-52. http://dx.doi.org/10.1016/S1388-9842(00)00087-8
de Mello Franco FG, Santos AC, Rondon MU, et al. Effects of home-based exercise training on neurovascular control in patients with heart failure. Eur J Heart Fail 2006; 8: 851-5. http://dx.doi.org/10.1016/j.ejheart.2006.02.009
Kiilavuori K, Toivonen L, Näveri H, Leinonen H. Reversal of autonomic derangements by physical training in chronic heart failure assessed by heart rate variability. Eur Heart J 1995; 16: 490-5.
Adamopoulos S, Ponikowski P, Cerquetani E, et al. Circadian pattern of heart rate variability in chronic heart failure patients. Effects of physical training. Eur Heart J 1995; 16: 1380-6.
Ali A, Mehra MR, Malik FS, Lavie CJ, Bass D, Milani RV. Effects of aerobic exercise training on indices of ventricular repolarization in patients with chronic heart failure. Chest 1999; 116: 83-7. http://dx.doi.org/10.1378/chest.116.1.83
Piepoli M, Clark AL, Coats AJ. Muscle metaboreceptors in hemodynamic, autonomic, and ventilatory responses to exercise in men. Am J Physiol 1995; 269: H1428-36.
Kaufman MP, Forster HV. Reflexes controlling circulatory, ventilatory and airway responses to exercise. In: Rowell LB, Shepherd JT, editors. Handbook of physiology, section 12, Exercise: regulation and integration of multiple systems. New York: American Physiological Society, Oxford University Press; 1996. p. 381-447.
Piepoli M, Ponikowski P, Clark AL, Banasiak W, Capucci A, Coats AJ. A neural link to explain the “muscle hypothesis” of exercise intolerance in chronic heart failure. Am Heart J 1999; 137: 1050-6. http://dx.doi.org/10.1016/S0002-8703(99)70361-3
Coats A, Clark A, Piepoli M, Volterrani M, Poole-Wilson PA. Symptoms and quality of life in heart failure: the muscle hypothesis. Br Heart J 1994; 72: S36-9. http://dx.doi.org/10.1136/hrt.72.2_Suppl.S36
Scott AC, Wensel R, Davos CH, et al. Skeletal muscle reflex in heart failure patients: role of hydrogen. Circulation 2003; 107: 300-6. http://dx.doi.org/10.1161/01.CIR.0000042704.37387.29
McCloskey DI, Mitchell JH. Reflex cardiovascular and respiratory responses originating in exercising muscle. J Physiol 1972; 224: 173-86.
Kao FF. An experimental study of the pathways involved in exercise hyperpnea employing cross-circulation technique. In: Cunningham DJC, Lloyd BB, editors. The Regulation of Human Respiration. Oxford, UK: Blackwell Scientific Publications; 1963. p. 461-502.
Scott AC, Wensel R, Davos CH, et al. Putative contribution of prostaglandin and bradykinin to muscle reflex hyperactivity in patients on Ace-inhibitor therapy for chronic heart failure. Eur Heart J 2004; 25: 1806-13. http://dx.doi.org/10.1016/j.ehj.2004.07.018
Ponikowski PP, Chua TP, Francis DP, Capucci A, Coats AJ, Piepoli MF. Muscle ergoreceptor overactivity reflects deterioration in clinical status and cardiorespiratory reflex control in chronic heart failure. Circulation 2001; 104: 2324-30. http://dx.doi.org/10.1161/hc4401.098491
Piepoli M, Clark AL, Volterrani M, Adamopoulos S, Sleight P, Coats AJ. Contribution of muscle afferents to the hemodynamic, autonomic, and ventilatory responses to exercise in patients with chronic heart failure. Effects of physical training. Circulation 1996; 93: 940-52. http://dx.doi.org/10.1161/01.CIR.93.5.940
Aukrust P, Ueland T, Müller F, et al. Elevated circulating levels of C-C chemokines in patients with congestive heart failure. Circulation 1998; 97: 1136-43. http://dx.doi.org/10.1161/01.CIR.97.12.1136
Tsutamoto T, Hisanaga T, Wada A, et al. Interleukin-6 spillover in the peripheral circulation increases with the severity of heart failure, and the high plasma level of interleukin-6 is an important prognostic predictor in patients with congestive heart failure. J Am Coll Cardiol 1998; 31: 391-8. http://dx.doi.org/10.1016/S0735-1097(97)00494-4
Torre-Amione G, Kapadia S, Benedict C, Oral H, Young JB, Mann DL. Proinflammatory cytokine levels in patients with depressed left ventricular ejection fraction: a report from the Studies of Left Ventricular Dysfunction (SOLVD). J Am Coll Cardiol 1996; 27: 1201-6. http://dx.doi.org/10.1016/0735-1097(95)00589-7
Bozkurt B, Kribbs SB, Clubb FJ, et al. Pathophysiologically relevant concentrations of tumor necrosis factor-α promote progressive left ventricular dysfunction and remodeling in rats. Circulation 1998; 97: 1382-91. http://dx.doi.org/10.1161/01.CIR.97.14.1382
McTiernan CF, Lemster BH, Frye C, Brooks S, Combes A, Feldman AM. Interleukin-1 beta inhibits phospholamban gene expression in cultured cardiomyocytes. Circ Res 1997; 81: 493-503. http://dx.doi.org/10.1161/01.RES.81.4.493
Ferdinandy P, Danial H, Ambrus I, Rothery RA, Schulz R. Peroxynitrite is a major contributor to cytokine-induced myocardial contractile failure. Circ Res 2000; 87: 241-7. http://dx.doi.org/10.1161/01.RES.87.3.241
Rössig L, Fichtlscherer S, Heeschen C, Berger J, Dimmeler S, Zeiher AM. The pro-apoptotic serum activity is an independent mortality predictor of patients with heart failure. Eur Heart J 2004; 25: 1620-5. http://dx.doi.org/10.1016/j.ehj.2004.06.036
Clapp BR, Hingorani AD, Kharbanda RK, et al. Inflammation-induced endothelial dysfunction involves reduced nitric oxide bioavailability and increased oxidant stress. Cardiovasc Res 2004; 64: 172-8. http://dx.doi.org/10.1016/j.cardiores.2004.06.020
Noutsias M, Seeberg B, Schultheiss HP, Kühl U. Expression of cell adhesion molecules in dilated cardiomyopathy: evidence for endothelial activation in inflammatory cardiomyopathy. Circulation 1999; 99: 2124-31. http://dx.doi.org/10.1161/01.CIR.99.16.2124
Hambrecht R, Adams V, Gielen S, et al. Exercise intolerance in patients with chronic heart failure and increased expression of inducible nitric oxide synthase in the skeletal muscle. J Am Coll Cardiol 1999; 33: 174-9. http://dx.doi.org/10.1016/S0735-1097(98)00531-2
Adams V, Nehrhoff B, Späte U, et al. Induction of iNOS expression in skeletal muscle by IL-1beta and NFkappaB activation: an in vitro and in vivo study. Cardiovasc Res 2002; 54: 95-104. http://dx.doi.org/10.1016/S0008-6363(02)00228-6
Hambrecht R, Schulze PC, Gielen S, et al. Reduction of insulin-like growth factor-I expression in the skeletal muscle of noncachectic patients with chronic heart failure. J Am Coll Cardiol 2002; 39: 1175-81. http://dx.doi.org/10.1016/S0735-1097(02)01736-9
Anker SD, Ponikowski PP, Clark AL, et al. Cytokines and neurohormones relating to body composition alterations in the wasting syndrome of chronic heart failure. Eur Heart J 1999; 20: 683-93. http://dx.doi.org/10.1053/euhj.1998.1446
Nunes RB, Tonetto M, Machado N, et al. Physical exercise improves plasmatic levels of IL-10, left ventricular end-diastolic pressure, and muscle lipid peroxidation in chronic heart failure rats. J Appl Physiol 2008; 104: 1641-7. http://dx.doi.org/10.1152/japplphysiol.00062.2008
Batista ML Jr, Santos RV, Lopes RD, Lopes AC, Costa Rosa LF, Seelaender MC. Endurance training modulates lymphocyte function in rats with post-MI CHF. Med Sci Sports Exerc 2008; 40: 549-56. http://dx.doi.org/10.1249/MSS.0b013e31815ed6d2
Batista ML Jr, Santos RV, Oliveira EM, Seelaender MC, Costa Rosa LF. Endurance training restores peritoneal macrophage function in post-MI congestive heart failure rats. J Appl Physiol 2007; 102: 2033-9. http://dx.doi.org/10.1152/japplphysiol.00871.2006
Conraads VM, Beckers P, Bosmans J, et al. Combined endurance/resistance training reduces plasma TNF-alpha receptor levels in patients with chronic heart failure and coronary artery disease. Eur Heart J 2002; 23: 1854-60. http://dx.doi.org/10.1053/euhj.2002.3239
Adamopoulos S, Parissis J, Karatzas D, et al. Physical training modulates proinflammatory cytokines and the soluble Fas/soluble Fas ligand system in patients with chronic heart failure. J Am Coll Cardiol 2002; 39: 653-63. http://dx.doi.org/10.1016/S0735-1097(01)01795-8
Adamopoulos S, Parissis J, Kroupis C, et al. Physical training reduces peripheral markers of inflammation in patients with chronic heart failure. Eur Heart J 2001; 22: 791-7. http://dx.doi.org/10.1053/euhj.2000.2285
Bjornstad HH, Bruvik J, Bjornstad AB, Hjellestad BL, Damås JK, Aukrust P. Exercise training decreases plasma levels of soluble CD40 ligand and P-selectin in patients with chronic heart failure. Eur J Cardiovasc Prev Rehabil 2008; 15: 43-8. http://dx.doi.org/10.1097/HJR.0b013e3281ca7023
Gielen S, Adams V, Linke A, et al. Exercise training in chronic heart failure: correlation between reduced local inflammation and improved oxidative capacity in the skeletal muscle. Eur J Cardiovasc Prev Rehabil 2005; 12: 393-400. http://dx.doi.org/10.1097/01.hjr.0000174824.94892.43
Jourdain P, Funck F, Canault E, et al. Value of type B natriuretic peptide in the emergency management of patients with suspected cardiac failure. Report of 125 cases. Arch Mal Coeur Vaiss 2002; 95: 763-7.
McCullough PA. B-type natriuretic peptide and its clinical implications in heart failure. Am Heart Hosp J 2004; 2: 26-33. http://dx.doi.org/10.1111/j.1541-9215.2004.03312.x
Maisel A. B-type natriuretic peptide levels: diagnostic and prognostic in congestive heart failure: what's next? Circulation 2002; 105: 2328-31. http://dx.doi.org/10.1161/01.CIR.0000019121.91548.C2
Smart NA, Steele M. Systematic review of the effect of aerobic and resistance exercise training on systemic brain natriuretic peptide (BNP) and N-terminal BNP expression in heart failure patients. Int J Cardiol 2010; 140: 260-5. http://dx.doi.org/10.1016/j.ijcard.2009.07.004
Schocken DD, Arrieta MI, Leaverton PE, Ross EA. Prevalence and mortality rate of congestive heart failure in the United States. J Am Coll Cardiol 1992; 20: 301-6. http://dx.doi.org/10.1016/0735-1097(92)90094-4
Tyni-Lenné R, Gordon A, Sylvén C. Improved quality of life in chronic heart failure patients following local endurance training with leg muscles. J Card Fail 1996; 2: 111-7. http://dx.doi.org/10.1016/S1071-9164(96)80029-7
Sullivan MJ, Hawthorne MH. Exercise intolerance in patients with chronic heart failure. Prog Cardiovasc Dis 1995; 38: 1-22. http://dx.doi.org/10.1016/S0033-0620(05)80011-8
Piepoli MF, Davos C, Francis DP, Coats AJ; ExTraMATCH Collaborative. Exercise training meta-analysis of trials in patients with chronic heart failure (ExTraMATCH). BMJ 2004; 328: 189-96. http://dx.doi.org/10.1136/bmj.37938.645220.EE
Rees K, Taylor RS, Singh S, Coats AJ, Ebrahim S. Exercise based rehabilitation for heart failure. Cochrane Database Syst Rev 2004; (3): CD003331.
Davies EJ, Moxham T, Rees K, et al. Exercise training for systolic heart failure: Cochrane systematic review and metaanalysis.Eur J Heart Fail 2010; 12: 706-15. http://dx.doi.org/10.1093/eurjhf/hfq056
Lloyd-Williams F, Mair FS, Leitner M. Exercise training and heart failure: a systematic review of current evidence. Br J Gen Pract 2002; 52: 47-55.
Monpère C, Sellier P, Meurin P, et al. Recommendation de la Société Française de Cardiologie concernant la pratique de la réadaptation cardiovasculaire chez l’adulte. Arch. Mal. Coeur Vaiss 2002; 95: 963-97.
Piña IL, Apstein CS, Balady GJ, et al. Exercise and heart failure: A statement from the American Heart Association Committee on exercise, rehabilitation, and prevention. Circulation 2003; 107: 1210-25. http://dx.doi.org/10.1161/01.CIR.0000055013.92097.40
O’Conner MC, Ahmad T, et al. Can we prevent heart failure with exercise. J Am Coll Cardiol 2012; 60: 2540-1.
Whellan DJ, et al. Long-Term Exercise Training and Adherence. J Am Coll Cardiol 2012; 60: 1520-21. http://dx.doi.org/10.1016/j.jacc.2012.07.018
Bellotto F, Compostella L, Agostoni P, et al. Peripheral Adaptation Mechanisms in Physical Training and Cardiac Rehabilitation: The Case of a Patient Supported by a Cardiowest Total Artificial Heart. J Cardiac Fail 2011; 17: 670-5. http://dx.doi.org/10.1016/j.cardfail.2011.04.006
Teffaha D, Mourot L, Vernochet P, et al. Relevance of water gymnastics in rehabilitation programs in patients with chronic heart failure or coronary artery disease with normal left ventricular function. J Cardiac Fail 2011; 17: 676-83. http://dx.doi.org/10.1016/j.cardfail.2011.04.008
Cattadori G, Schmid JP, Brugger N, et al. Hemodynamic effects of exercise training in heart failure. J Cardiac Fail 2011; 17: 916-22. http://dx.doi.org/10.1016/j.cardfail.2011.07.010
Jankowska EA, Rozentryt P, Witkowska A, Nowak J, Hartman O, Ponikowska B, Nadziela LB, Haehling SV, Doehner W, Banasiak W, Polonski L, Gerasmos F, Anker S, Ponikowski P, et al. Iron Deficiency Predicts Impaired Exercise Capacity in Patients with Systolic Chronic Heart Failure. J Cardiac Fail 2011; 17: 899-906. http://dx.doi.org/10.1016/j.cardfail.2011.08.003
Meyer P, Normandin E, Gayda M, et al. High-Intensity Interval Exercise in Chronic Heart Failure: Protocol Optimization. J Cardiac Fail 2012; 18: 126-33. http://dx.doi.org/10.1016/j.cardfail.2011.10.010
