EFFECTS OF PHYSICAL-TRAINING IN CHRONIC HEART-FAILURE

Eleven patients with chronic heart failure secondary to ischaemic heart disease (mean [SEM] age 63·0 [2·3] years; left ventricular ejection fraction 19 [8]%) undertook 8 weeks of home-based bicycle exercise training and 8 weeks of activity restriction (rest) in a physician-blind, random-order, crossover trial. Training increased exercise duration from 14·2 (1·1) min to 16·8 (1·3) min and peak oxygen consumption from 14·3 (1·1) ml.min-1.kg-1 to 16·7 (1·3) ml.min-1.kg-1. Heart rates at submaximum workloads and rate-pressure products were significantly reduced by training, and there was also a significant improvement in patient-rated symptom scores. No adverse events occurred during the training phase. Thus home-based physical training programmes are feasible even in severe chronic heart failure and have a beneficial effect on exercise tolerance, peak oxygen consumption, and symptoms. The commonly held belief that rest is the mainstay of treatment of chronic heart failure should no longer be accepted. © 1990.