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

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Abstract

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.

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Funding

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

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Author notes

  1. Jirka Cops and Sibren Haesen contributed equally to this work.

Authors and Affiliations

  1. BIOMED – Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, BE-3500, Hasselt, Belgium

    Jirka Cops, Sibren Haesen, Bart De Moor, Wilfried Mullens & Dominique Hansen

  2. Doctoral School for Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium

    Jirka Cops

  3. Department of Nephrology, Jessa Ziekenhuis, Hasselt, Belgium

    Bart De Moor

  4. Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium

    Wilfried Mullens

  5. REVAL – Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium

    Dominique Hansen

  6. Heart Centre Hasselt, Jessa Ziekenhuis, Hasselt, Belgium

    Dominique Hansen

Authors
  1. Jirka Cops
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  2. Sibren Haesen
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  3. Bart De Moor
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  4. Wilfried Mullens
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  5. Dominique Hansen
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Correspondence to Jirka Cops.

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Cops, J., Haesen, S., De Moor, B. et al. Exercise intervention in hospitalized heart failure patients, with emphasis on congestion-related complications: a review. Heart Fail Rev 25, 257–268 (2020). https://doi.org/10.1007/s10741-019-09833-x

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  • DOI: https://doi.org/10.1007/s10741-019-09833-x

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