Key result
Exercise training reduces MLHFQ scores by ~26% vs control in heart failure patients post-CRT.
Why the study?
Although cardiac resynchronization therapy improves outcomes in chronic heart failure, the effect of combined exercise training and CRT on quality of life, functional class, exercise capacity, and LVEF needed evaluation.
Does exercise training improve quality of life, functional class, exercise capacity, and LVEF in chronic heart failure patients post-cardiac resynchronization therapy?
RCT (n=20)
Randomized to two equal groups
No
Does exercise training improve quality of life, functional class, exercise capacity, and LVEF in chronic heart failure patients post-cardiac resynchronization therapy?
Exercise training following cardiac resynchronization therapy provides additive benefits in improving quality of life, functional capacity, and left ventricular ejection fraction in patients with chronic heart failure.
Exercise training may improve QoL post-CRT; hypothesis-generating and requires RCTs before practice change.
Background: Cardiac resynchronization therapy (CRT) results in improved morbidity, mortality, symptoms, quality of life (QOL) and exercise capacity, in appropriate chronic heart failure (CHF) patients. Moreover, combined exercise training (ET) and CRT maximize these improvements in these patients. The study evaluated the effect of ET on these patients in terms of QOL, functional class, exercise capacity and left ventricular ejection fraction (LVEF). Results: There were significant improvements in the QOL, functional class, exercise capacity, and LVEF compared with the Control Group. Comparison of both groups confirmed the cumulative effects of ET with CRT. The QOL improved by the end of training in the exercise group (p = 0.001), compared to the Control Group (p = 0.850). NYHA functional class improved significantly in the Exercise Group (p = 0.013). Percent-predicted peak oxygen consumption (VO2 peak) had significantly improved in the trained (p 0.001) versus the untrained CRT Group (p= 0.596). There was a mean percent rise of the ejection fraction from 39.2 ± 12.86 to 44.40% ± 14.42% in the Exercise Group compared to a non-significant change in the Control Group. Conclusion: ET in resynchronized CHF patients is feasible and further enhances QOL and exercise tolerance in addition to the improvements seen after CRT. The study therefore recommends for the prescription of ET after implantation in order to maximize the expected benefit.
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Kamal et al. (2021) conducted an RCT in Chronic Heart Failure post Cardiac Resynchronization Therapy (n=20). Exercise training vs. Control (no exercise training) was evaluated on Quality of Life (MLHFQ score) (p=0.031). Exercise training significantly improved quality of life, reducing the MLHFQ score to 54.0 compared to 73.40 in the control group, in chronic heart failure patients post-cardiac resynchronization therapy.
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