QUALITY-OF-LIFE AND CARDIORESPIRATORY FUNCTION IN CHRONIC HEART-FAILURE - EFFECTS OF 12 MONTHS AEROBIC TRAINING

Objective-To examine the long-term benefits and safety of aerobic trai ning in patients with chronic heart failure. Design-Non-randomised con trol trial with 52 weeks follow up. Setting-Outpatient cardiac rehabil itation referral centre. Patients-Patients with compensated chronic he art failure (mean (SD) age 62 (6) years, New York Heart Association st age III, initial resting ejection fraction 22 (7)%). Experimental grou p of 17 men, 4 women; control group 8 men, 1 woman. Interventions-Expe rimental group: progressive, supervised aerobic walking programme for 52 weeks. Control group: standard medical treatment. Main outcome meas ures-Six-minute walk distance, progressive cycle ergometer test to sub jective exhaustion, disease-specific quality of life questionnaire, an d standard gamble test, all measured at entry, 4, 8, 12, 16, 26, and 5 2 weeks. Results-Control data showed no changes except a small trend t o improved emotional function (P = 0.02 at 12 weeks only). Fifteen of the 21 patients completed all 52 weeks of aerobic training; two withdr ew for non-cardiac reasons (16, 52 weeks). Three were withdrawn becaus e of worsening cardiac failure unrelated to their exercise participati on (4, 4, 8 weeks), and one had a non-fatal cardiac arrest while shopp ing (16 weeks). Gains of cardiorespiratory function plateaued at 16-26 weeks, with 10-15% improvement in six-minute walk, peak power output, and peak oxygen intake linked to gains in oxygen pulse and ventilator y threshold and reductions in resting heart rate. Marked improvements in quality of life followed a parallel course. Conclusions-Aerobic tra ining is safe and beneficial in compensated chronic heart failure. Gai ns in aerobic function and quality of life persisted over a programme lasting 52 weeks.