Supervised endurance exercise training in older HFrEF patients yielded no significant differences in peak VO2 compared to usual care, though 26% of patients increased VO2 peak by ≥10%.
RCT (n=59)
Single-blind
Randomly assigned
Does a 16-week supervised endurance exercise training program improve peak exercise oxygen consumption, left ventricular function, and quality of life in older patients with HFrEF?
A 16-week supervised endurance exercise training program failed to produce consistent benefits in exercise capacity, LV function, or quality of life in older patients with HFrEF.
OBJECTIVES: To test the hypothesis that exercise training (ET) improves exercise capacity and other clinical outcomes in older persons with heart failure with reduced ejection fraction (HfrEF). DESIGN: Randomized, controlled, single-blind trial. SETTING: Outpatient cardiac rehabilitation program. PARTICIPANTS: Fifty-nine patients aged 60 and older with HFrEF recruited from hospital records and referring physicians were randomly assigned to a 16-week supervised ET program (n=30) or an attention-control, nonexercise, usual care control group (n=29). INTERVENTION: Sixteen-week supervised ET program of endurance exercise (walking and stationary cycling) three times per week for 30 to 40 minutes at moderate intensity regulated according to heart rate and perceived exertion. MEASUREMENTS: Individuals blinded to group assignment assessed four domains pivotal to HFrEF pathophysiology: exercise performance, left ventricular (LV) function, neuroendocrine activation, and health-related quality of life (QOL). RESULTS: At follow-up, the ET group had significantly greater exercise time and workload than the control group, but there were no significant differences between the groups for the primary outcomes: peak exercise oxygen consumption (VO(2) peak), ventilatory anaerobic threshold (VAT), 6-minute walk distance, QOL, LV volumes, EF, or diastolic filling. Other than serum aldosterone, there were no significant differences after ET in other neuroendocrine measurements. Despite a lack of a group "training" effect, a subset (26%) of individuals increased VO(2) peak by 10% or more and improved other clinical variables as well. CONCLUSION: In older patients with HFrEF, ET failed to produce consistent benefits in any of the four pivotal domains of HF that were examined, although the heterogeneous response of older patients with HFrEF to ET requires further investigation to better determine which patients with HFrEF will respond favorably to ET.
Brubaker et al. (Tue,) conducted a rct in Heart failure with reduced ejection fraction (HFrEF) (n=59). Supervised endurance exercise training vs. Attention-control, nonexercise, usual care was evaluated on Peak exercise oxygen consumption (VO2 peak), ventilatory anaerobic threshold (VAT), 6-minute walk distance, QOL, LV volumes, EF, or diastolic filling. Supervised endurance exercise training in older HFrEF patients yielded no significant differences in peak VO2 compared to usual care, though 26% of patients increased VO2 peak by ≥10%.