EXERCISE TESTING AND TRAINING IN CHI PATI ENTS

In patients with chronic heart failure (CHI) exercise testing is condu cted to assess functional capacity and symptoms related to physical pe rformance, for determination of prognosis, and for determination of ef fects of medical treatment and exercise training. Considerations disti nguishing CHI patients in subgroups of good or poor short-term prognos is based on fixed peak oxygen uptake and control of therapeutic interv ention ape significantly influenced by test routine. Exercise testing is a prerequisite of exercise prescription. Training is prescribed by the mode or type of exercise, frequency of participation, duration and intensity of exercise bout. Low intensive workloads of long duration or repetitive bouts of high intensive short duration exercise have bee n an effective tool to enhance exercise capacity in CHI patients. Most studies have used moderate training intensity between 50 and 75% of p eak oxygen uptake during 60 to 90 min of net exercise time per week. H eart rate, lactate, and rating of perceived exertion serve as measures for determination of training intensity. However, reliability and val idity of given methods for monitoring may be reduced because of impair ment of exercise response characteristic for CHI. More studies are nee ded to elucidate the mechanisms involved in exercise induced adaptatio ns in CHI patients and to evaluate the utility of given training progr ams associated with beneficial effects on exercise capacity and progno sis.