Exercise Training for Heart Failure

e have known for many years of the benefits of an exercise component in cardiac rehabilitation. It was initially thought that significant left ventricular impairment was a contraindication to participation in such programs. 3] Pioneering work from Duke University showed a significant enhancement in exercise capacity and ancillary physiological benefits, including reduced lactate production, improved use of ventilatory reserve, and increased leg blood flow during progressive exercise. This was quickly followed by the first prospective controlled trial of exercise training in CHF, an 11-patient crossover study of home-based exercise training using a cycle ergometer for 8 weeks versus a similar period of activity restriction. The result was an improvement in exercise capacity and an improvement in questionnaire-based heart failure-related symptoms. The era of training as a treatment of heart failure had begun.