Effects of exercise training on peak performance and quality of life in congestive heart failure patients

Gottlieb, Stephen S.; Fisher, Michael L.; Freudenberger, Ronald; Robinson, Shawn; Zietowski, Gretchen; Alves, Lynette; Krichten, Catherine; Vaitkevicus, Peter; Mccarter, Robert

« Previous Next »Journal of Cardiac Failure
Volume 5, Issue 3 , Pages 188-194, September 1999

Effects of exercise training on peak performance and quality of life in congestive heart failure patients☆

Stephen S. Gottlieb, MD
- Reprint requests: Stephen S. Gottlieb, MD, Division of Cardiology, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, MD 21201.
- Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Veterans Affairs Medical Center, Baltimore, Maryland, USA
Michael L. Fisher, MD
- Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Veterans Affairs Medical Center, Baltimore, Maryland, USA
Ronald Freudenberger, MD
- Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
Shawn Robinson, MD
- Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
Gretchen Zietowski, MS, RN
- Department of Veterans Affairs Medical Center, Baltimore, Maryland, USA
Lynette Alves, MS
- Department of Veterans Affairs Medical Center, Baltimore, Maryland, USA
Catherine Krichten, RN, CRNP
- Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
Peter Vaitkevicus, MD
- Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Veterans Affairs Medical Center, Baltimore, Maryland, USA
Robert Mccarter, ScD
- Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA

Received 15 February 1999; received in revised form 19 April 1999; accepted 19 April 1999.

Abstract

Background: Exercise programs for patients with heart failure have often enrolled and evaluated relatively healthy, young patients. They also have not measured the impact of exercise performance on daily activities and quality of life.

Methods and Results: We investigated the impact of a 6-month supervised and graded exercise program in 33 elderly patients with moderate to severe heart failure randomized to usual care or an exercise program. Six of 17 patients did not tolerate the exercise program. Of those who did, peak oxygen consumption increased by 2.4 ± 2.8 mL/kg/min (P < .05) and 6-minute walk increased by 194 ft (P < .05). However, outpatient energy expenditure did not increase, as measured by either the doubly labeled water technique or Caltrac accelerometer. Perceived quality of life also did not improve, as measured by the Medical Outcomes Study, Functional Status Assessment, or Minnesota Living With Heart Failure questionnaires.

Conclusion: Elderly patients with severe heart failure can safely exercise, with an improvement in peak exercise tolerance. However, not all patients will benefit, and daily energy expenditure and quality of life do not improve to the same extent as peak exercise.

Keywords: exercise therapy, heart failure, quality of life, functional status

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