Exercise intervention in hospitalized heart failure patients, with emphasis on congestion-related complications: a review

  • Jirka CopsEmail author
  • Sibren Haesen
  • Bart De Moor
  • Wilfried Mullens
  • Dominique Hansen


The importance of physical activity has become evident since a sedentary lifestyle drives cardiovascular disease progression and is associated with increased morbidity and mortality. The favorable effects of exercise training in chronic heart failure (HF) and chronic kidney disease (CKD) are widely recognized and exercise training is recommended by European and American guidelines. However, the application of exercise intervention in HF patients hospitalized for acute decompensation or acute worsening in cardiac function has not been explored extensively and, as a result, knowledge about the effects of exercise training in the inpatient setting of acute HF is limited. Acute HF is often accompanied by signs and symptoms of congestion, termed acute decompensated heart failure (ADHF), which leads to worsening renal function (WRF) and eventually negatively affects both thoracic and abdominal organs. Therefore, we first provide a comprehensive overview of the impact of exercise training in hospitalized patients demonstrating acute decompensating HF. In the second part, we will focus on the effects of exercise training on congestion in a setting of ADHF complicated by renal dysfunction. This review suggests that exercise intervention is beneficial in the inpatient setting of acute HF, but that more clinical studies focusing on the application of exercise training to counteract venous congestion are needed.


Exercise training Electrical muscle stimulation Acute decompensating heart failure Venous congestion Worsening renal function 



This work was funded by Bijzonder Onderzoeks Fonds (BOF) from UHasselt/BIOMED to JC.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Since this is a review article, this article does not contain any studies with human participants or animals performed by any of the authors.


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.BIOMED – Biomedical Research Institute, Faculty of Medicine and Life SciencesHasselt UniversityHasseltBelgium
  2. 2.Doctoral School for Medicine and Life SciencesHasselt UniversityDiepenbeekBelgium
  3. 3.Department of NephrologyJessa ZiekenhuisHasseltBelgium
  4. 4.Department of CardiologyZiekenhuis Oost-LimburgGenkBelgium
  5. 5.REVAL – Rehabilitation Research Center, Faculty of Rehabilitation SciencesHasselt UniversityDiepenbeekBelgium
  6. 6.Heart Centre HasseltJessa ZiekenhuisHasseltBelgium

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