Heart failure
Long-Term Effects of a Group-Based High-Intensity Aerobic Interval-Training Program in Patients With Chronic Heart Failure

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Studies on the long-term effects of exercise training programs on functional capacity and the quality of life in patients with chronic heart failure (CHF) are sparse. The aim of this study was to evaluate the long-term effects of group-based, high-intensity interval training on functional capacity and the quality of life in 80 patients with stable CHF (mean age 70.1 ± 7.9 years) in New York Heart Association classes II to IIIB. Patients were randomized to either an exercise group (n = 40) or a control group (n = 40). The mean ejection fractions at baseline were 31 ± 8% in the exercise group and 31 ± 1% in the control group. The exercise group exercised twice a week for 4 months in addition to 4 consultations with a CHF nurse. Six-minute walking distance, workload and exercise time on a cycle ergometer test, and the quality of life were measured at baseline and 4 and 12 months after enrollment. After 4 months, functional capacity (6-minute walking distance +58 vs −15 m, p <0.001) and the quality of life (Minnesota Living With Heart Failure Questionnaire score +10 vs −1 point, p <0.005) improved significantly in the exercise group compared with the control group. After 12 months, the improvements were still significant in the exercise group compared with the control group for all parameters (6-minute walking distance +41 vs −20 m, p <0.001; workload +10 vs −1 W, p = 0.001; exercise time +53 vs −6 seconds, p = 0.003; quality of life +10 vs −6 points, p = 0.003). In conclusion, the results support the implementation of a group-based aerobic interval training program to improve long-term effects on functional capacity and the quality of life in patients with CHF.

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Methods

The study population was obtained by screening all patients with CHF who were referred to the heart failure outpatient clinics at Ullevaal University Hospital and Lovisenberg Hospital (both in Oslo, Norway) during a 2.5-year period. Ninety-five patients were candidates for inclusion in the study, but 15 patients withdrew consent for various reasons. A study flow diagram is presented in Figure 1. The study was a prospective randomized controlled trial. The patients were randomized to either the

Results

At baseline, there were no significant differences in demographic data; time between time 1, time 2, and time 3; or medical treatment (Table 1). Medical treatment did not change during the intervention period, except for alterations in diuretic dosages (as is normal in clinical practice) and temporary medication changes during hospitalization. No events occurred during the exercise training. Of the 76 patients who completed the tests after the intervention period, 72 returned for evaluation 1

Discussion

This study is, to our knowledge, the first to document long-term effects on functional capacity and the quality of life in patients with CHF using a novel group-based, high-intensity aerobic interval training program. Our main hypothesis in this trial was confirmed.

Previous studies have been generally concordant in demonstrating an increase in functional capacity after short-term exercise training, but few comparable studies have evaluated whether patients with CHF continue to carry out

Acknowledgment

We acknowledge the assistance of physicians Svein Solheim, Haakon Kiil Grøgard, and Torstein Jensen, of the Department of Cardiology, and the fellows of the Heart Laboratory and Cardiology Unit at Ullevaal University Hospital with the cycle ergometer tests.

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    This study was supported by grants from the Eastern Norwegian Health Authority, the Norwegian Foundation for Health and Rehabilitation, and the Center for Clinical Research, Ullevaal University Hospital, Oslo, Norway.

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