Exercise Training in Patients With Stable Chronic Heart Failure

In Brief PURPOSE Recent evidence has suggested that patients with stable chronic heart failure (CHF) may respond favorably to a progressive exercise program. The use of noninvasive hemodynamic monitoring and B-type natriuretic peptide (BNP) measurement in these patients is not well reported. This study investigated the utility of noninvasive hemodynamic monitoring and point-of-care BNP in a cardiac rehabilitation outpatient setting. METHODS Patients with stable CHF were assigned to a supervised 12-week exercise program (n = 13) or control (n = 6). At baseline and at the end of the study period, patients were assessed for functional and quality-of-life status. Point-of-care BNP and noninvasive hemodynamic parameters were also obtained. RESULTS As expected, patients assigned to the exercise group showed significant improvement in quality of life and distance covered by the 6-minute walk test, but control subjects showed no such changes. There was a trend toward improved BNP in the exercise group, with 73% of these patients showing a decrease in comparison with 67% of controls showing an increase. There was a significant improvement in stroke volume in the exercise group but not in the control group. CONCLUSIONS Both BNP and noninvasive hemodynamic monitoring can be utilized in the cardiac rehabilitation outpatient setting and seem to mirror the favorable response to exercise of other functional tests. The point-of-care measurement of B-type natriuretic peptide and noninvasive cardiac output was successfully utilized in a cardiac rehabilitation outpatient setting to evaluate the effects of prescribed exercise on exercise tolerance. Changes in these parameters following exercise training mirrored the favorable changes seen in other functional tests.