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Exercise Might Benefit Some With Heart Failure
Date:4/7/2009

prognostic predictors of the primary endpoint," such as the presence of the heartbeat abnormality called atrial fibrillation, ability to perform on a cardiopulmonary exercise test and the blood-pumping measure called left ventricular ejection fraction.

After that adjustment, the researchers found that exercise reduced the incidence of hospitalization by 11 percent and cardiovascular death or heart failure hospitalization by 15 percent.

But exercise had other benefits, O'Connor said. "Significantly more patients had an improvement on the quality-of-life scale with exercise training than those who did not exercise," he said. "Exercise training also improves physical fitness level to a modest degree. These people are able to walk further and exercise longer on a treadmill."

A separate analysis also showed a lower incidence of depression in the exercise group.

The overall analysis showed better survival for people who actually stuck to the recommended exercise regimen, O'Connor said. Overall, adherence decreased from an average of 95 minutes a week to 74 minutes a week after a year. But that result, which he said would be described in a future paper, cannot be relied on, because it might simply be that people who felt better overall were the more likely to exercise, he said.

All things considered, O'Connor said, "my belief, based on these results and when you look at the totality of information, is that an exercise prescription should be offered to patients with heart failure who meet our entry criteria."

And, at the very least, "we can say that we've shown in this study that exercise training is safe," he said. "There was no increase in mortality, in hip fractures and in falls in the exercise training group versus the control group."

The trial results could lead to a shift in advice given to people with heart failure, said Dr. Mariell Jessup, a professor of medicine at the University of Pennsylvania
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