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Can Exercise Conditioning be Effective in Older Heart Failure Patients?

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Abstract

Over the past two decades, considerable evidence has accrued that heart failure patients benefit from aerobic exercise training programs. Improvements in peak oxygen consumption and its components as well as increases in ventilatory threshold and submaximal endurance have been documented from such programs. Despite the fact that heart failure predominates among the elderly, very few training studies have included substantial numbers of older individuals, particularly older women. The limited data available suggests that older heart failure patients derive similar benefits from training as younger patients. A major challenge for the future is the inclusion of representative proportions of elderly individuals in heart failure training trials.

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References

  1. Buskirk ER, Hodgson JL. Age and aerobic power: the rate of change in men and women. Fed Proc 1987;46:1824-1829.

    Google Scholar 

  2. Fleg JL, Lakatta EG. Role of muscle loss in the age-associated reduction in VO2Max. J Appl Physiol 1988;65:1147-1151.

    Google Scholar 

  3. Fleg JL. The effect of normative aging on the cardio-vascular system. Am J Geriatr Cardiol 1994;3:25-31.

    Google Scholar 

  4. Fleg JL, O'Connor FC, Becker LC, et al. Cardiac versus peripheral contributions to the age-associated decline in aerobic capacity. J Am Coll Cardiol 1997;29:269A.

    Google Scholar 

  5. Ogawa T, Spine R, Martin III WH, Kohrt WM, et al. Effects of aging, sex, and physical training on cardio-vascular responses to exercise. Circulation 1992;86:494-503.

    Google Scholar 

  6. Fleg JL, O'Connor F, Gerstenblith, G et al. Impact of age on the cardiovascular response to dynamic upright exercise in healthy men and women. J Appl Physiol 1995;78:890-900.

    Google Scholar 

  7. Higginbotham MB, Morris KG, Conn EH, et al. Determinants of variable exercise performance among patients with severe left ventricular dysfunction. Am J Cardiol 1983;51:52-60.

    Google Scholar 

  8. Colucci WS, Ribeiro JP, Rocco MB, et al. Impaired chronotropic response to exercise in patients with congestive heart failure. Role of post-synaptic beta-adrenergic desensitization. Circulation 1989;80: 314-323.

    Google Scholar 

  9. Afzal A, Brawner CA, Keteyian SJ. Exercise training in heart failure. Progress in Cardiovascular Diseases 1998;41:175-190.

    Google Scholar 

  10. Badenhop DJ, Cleary PA, Schoal SF, Fox EL, Bartels RL. Physiological adjustments to higher-and lower-intensity exercise in elders. Med Sci Sports Exercise 1963;15:496-502.

    Google Scholar 

  11. Seals DR, Hagberg JM, Hurley BF, Ehsani AA, Holloszy JO. Endurance training in older men and women. I Cardiovascular response to exercise. J Appl Physiol 1984;57:1024-1029.

    Google Scholar 

  12. Hagberg JM, Graves JE, Limacher M, et al. Cardiovascular responses of 70-to 79-yr old men to exercise training. J Appl Physiol 1989;66:2589-2594.

    Google Scholar 

  13. Schulman SP, Fleg JL, Goldberg AP, et al. Continuum of cardiovascular performance across a broad range of fitness levels in healthy older men. Circulation 1996;94:359-367.

    Google Scholar 

  14. Williams MA, Maresh CM, Esterbrooks DJ, et al. Early exercise training in patients older than 65 years compared with that in younger patients after acute myocardial infarction or coronary artery bypass grafting. Am J Cardiol 1985;55:263-266.

    Google Scholar 

  15. Lavie CJ, Milani RV, Littman AB. Benefits of cardiac rehabilitation and exercise training in secondary coronary prevention in the elderly. J Am Coll Cardiol 1993;22:678-683.

    Google Scholar 

  16. Ades PA. Cardiac rehabilitation in older coronary patients. J Am Geriatr Soc 1999;47:98-105.

    Google Scholar 

  17. Ades PA, Waldmann ML, Meyer WL, et al. Skeletal muscle and cardiovascular adaptations to exercise conditioning in older coronary patients. Circulation 1996;94:323-330.

    Google Scholar 

  18. McDonald CD, Burch GE, Walsh JJ. Alcoholic cardi-omyopathy managed with prolonged bedrest. Ann Intern Med 1971;74:681-691.

    Google Scholar 

  19. Piepoli MF, Flather M, Coats AJS. Overview of studies of exercise training in chronic heart failure: the need for a prospective randomized multicentre European trial. European Heart J 1998;19:830-841.

    Google Scholar 

  20. Jugdutt BI, Michorowski BL, Kappagoda CT. Exercise training after anterior Q wave myocardial infarction: importance of regional left ventricular function and topography. J Am Coll Cardiol 1988;12:362-372.

    Google Scholar 

  21. Sullivan MJ, Higginbotham MB, Cobb FR. Exercise training in patients with severe left ventricular dysfunction: hemodynamic and metabolic effects. Circulation 1988;78:506-515.

    Google Scholar 

  22. Minotti JR, Johnson EC, Hudson TL, et al. Skeletal muscle response to exercise training in congestive heart failure. J Clin Invest 1990;86:751-758.

    Google Scholar 

  23. Adamopoulos S, Coats AJS, Brunotte F. Physical training improves skeletal muscle metabolism in patients with heart failure. J Am Coll Cardiol 1993;21:1101-1106.

    Google Scholar 

  24. Stratton JR, Dunn JF, Adamopoulos S, et al. Training partially reverses skeletal muscle metabolic abnormalities during exercise in heart failure. J Appl Physiol 1994;76:1575-1582.

    Google Scholar 

  25. Hambrecht R, Niebauer J, Fiehn E, et al. Physical training in patients with stable chronic heart failure. Effects on cardiorespiratory fitness and ultrastructural abnormalities of leg muscles. J Am Coll Cardiol 1995;25:1239-1245.

    Google Scholar 

  26. Katz SD, Yuen J, Bijou R. Training improves endothe-lium-dependent vasodilation in resistance vessels of patients with heart failure. J Appl Physiol 1997;82:1488-1492.

    Google Scholar 

  27. Coats AJS, Adamopoulos S, Radaelli A. Controlled trial of physical training in chronic heart failure. Circulation 1992;85:2119-2131.

    Google Scholar 

  28. Braith RW, Feigenbaum MS, Welsch MA, et al. Neuroendocrine hyperactivity in heart failure is buffered by endurance exercise. Circulation 1996;94:I–192.

    Google Scholar 

  29. European Heart Failure Group. Experience from controlled trials of physical training in chronic heart failure. European Heart J 1998;19:466-475.

    Google Scholar 

  30. Wielenga RP, Huisveld IA, Bol E, et al. Exercise training in elderly patients with chronic heart failure. Coronary Artery Disease 1998;9:765-770.

    Google Scholar 

  31. Gottlieb SS, Fisher ML, Freudenberger R, et al. Effect of exercise training on peak performance and quality of life in congestive heart failure patients. J Card Fail 1999;3:188-194.

    Google Scholar 

  32. Vaitkevicius PV, Ebersold C, Haydar Z, et al. The utility of exercise training to improve functional capacity of elderly heart failure patients. Circulation 1997;(Suppl) 96:I–85.

    Google Scholar 

  33. Belardinelli R, Georgiou D, Cianci G, Purcaro A. Randomized controlled trial of long-term moderate exercise training in chronic heart failure. Effects on functional capacity, quality of life, and clinical outcome. Circulation 1999;99:1173-1182.

    Google Scholar 

  34. Soufer R, Wohlgelernter D, Vita N, et al. Intact systo-lic left ventricular function in clinical congestive heart failure. Am J Cardiol 1985;55:1032-1036.

    Google Scholar 

  35. Vasan RS, Larson MG, Benjamin EJ, et al. Congestive heart failure in subjects with normal versus reduced left ventricular ejection fraction. Prevalence and mortality in a population-based cohort. J Am Coll Cardiol 1999;33:1948-1955.

    Google Scholar 

  36. Aronow WS, Ahn C, Kronzon I. Normal left ventricular ejection fraction in older persons with congestive heart failure. Chest 1988;113:867-869.

    Google Scholar 

  37. Wong WF, Gold S, Fukuyama O, et al. Diastolic dysfunction in elderly patients with congestive heart failure. Am J Cardiol 1989;63:1526-1528.

    Google Scholar 

  38. Mancini DM, Walter G, Reicheck N, et al. Contribution of skeletal muscle atrophy to exercise intolerance and altered muscle metabolism in heart failure. Circulation 1992;85:1364-1373.

    Google Scholar 

  39. Toth MJ, Gottlieb SS, Fisher ML, et al. Skeletal muscle atrophy and peak oxygen consumption in heart failure. Am J Cardiol 1997;79:1267-1269.

    Google Scholar 

  40. Drexler H, Reide V, Munzel T, et al. Alteration of skeletal muscle in chronic heart failure. Circulation 1992;85:1751-1759.

    Google Scholar 

  41. Kallman DA, Plato CC, Tobin JD. The role of muscle loss in the age-related decline of grip strength; cross-sectional and longitudinal perspectives. J Gerontol Med Sci 1990;45:M82-M88.

    Google Scholar 

  42. Faulker JA, Brooks SV, Zerba E. Muscle atrophy and weakness with aging: contraction-induced injury as an underlying mechanism. J Gerontol 1995;50A: 124-129.

    Google Scholar 

  43. Fiataroni MA, Marks EC, Ryan ND, et al. High intensity strength training in nonagenarians: effects on skeletal muscle. JAMA 1990;263:3029-3034.

    Google Scholar 

  44. Fiataroni MA, O'Neill EF, Ryan ND, et al. Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med 1994;330:1769-1775.

    Google Scholar 

  45. Hare DL, Ryan T, Selig SE, et al. Resistance exercise training increases muscle strength, endurance and blood flow in patients with chronic heart failure. Am J Cardiol 1999;83:1674-1677.

    Google Scholar 

  46. Braith RW, Welsch MA, Mills RM, et al. Resistance exercise prevents glucocorticord-induced myopathy in heart transplant recipients. Med Sci Sports Exerc 1998;30:483-489.

    Google Scholar 

  47. Braith RW, Mills RM, Welsch MA et al. Resistance exercise training restores BMD in heart transplant recipients. J Am Coll Cardiol 1997;28: 1471-1477.

    Google Scholar 

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Authors and Affiliations

  1. National Institute on Aging, National Institutes of Health, USA

    Jerome L. Fleg MD

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  1. Jerome L. Fleg MD
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Fleg, J.L. Can Exercise Conditioning be Effective in Older Heart Failure Patients?. Heart Fail Rev 7, 99–103 (2002). https://doi.org/10.1023/A:1013758008044

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