Abstract
Major conceptual changes in the management of patients with congestive heart failure have assumed even greater importance as newer therapies have alleviated or limited disabling symptoms and prolonged survival [1,2]. Protracted bed rest is no longer the recommended approach, nor are usual well-tolerated activities restricted. Rather, there is emphasis on the benefits of judiciously applied prescriptive exercise training for appropriately selected patients, with the goal of enhancing activity tolerance. This parallels the evolution from exercise restriction to exercise prescription in the management of patients with coronary heart disease and myocardial infarction.
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References
The CONCENSUS Trial Study Group (1987) Effects of enalapril on mortality in severe congestive heart failure. Results of the Cooperative North Scandinavian Enalapril Survival Study (CONCENSUS). N Engl J Med 316: 1429–1435
Cohn JN, Archibald DG, Ziesche S, Franciosa JA, Harston WE, Tristani FE, Dunkman WB, Jacobs W, Francis GS, Flohr KH, Goldman S, Cobb FR, Shah PM; Saunders R, Fletcher RD, Loeb HS, Hughes VC, Baker B (1986) Effect of vasodilator therapy on mortality in chronic congestive heart failure. Results of a Veterans Administration cooperative study. N Engl J Med 314: 1547–1552
Goldman L, Cook EF, Mitchell N, Flatley M, Sherman H, Cohn PF (1982) Pitfalls in the serial assessment of cardiac functional status. How a reduction in “ordinary” activity may reduce the apparent degree of cardiac compromise and give a misleading impression of improvements. J Chron Dis 35: 763–771
Franciosa JA (1986) Epidemiologic patterns, clinical evaluation, and long-term prognosis in chronic congestive heart failure. Am J Med 80 (Suppl 2B): 14–21
Guyatt GH (1985) Methodologic problems in clinical trials in heart failure. J Chron Dis 38: 353–363
Feinstein AR, Joseph BR, Wells CK (1986) Scientific and clinical problems in indexes of functional disability. Ann Intern Med 81: 641–664
Massie BM, Conway M, Rajagopalan B, Yonge R, Frostick S, Ledingham J, Sleight P, Radda G (1988) Skeletal muscle metabolism during exercise under ischemic conditions in congestive heart failure. Evidence for abnormalities unrelated to blood flow. Circulation 78: 320–326
Lipkin DP, Jones DA, Round JM, Poole-Wilson PA (1985) Maximal force, fibre type, and enzymatic activity in quadriceps of patients with severe heart failure: a mechanism for reduced exercise capacity (abstract). Br Heart J 54: 622
Lipkin DP, Canepa-Anson R, Stephens MR, Poole-Wilson PA (1986) Factors determining symptoms in chronic heart failure: comparison of fast and slow exercise tests. Br Heart J 55: 439–445
Baker BJ, Wilen MM, Boyd CM, Dinh H, Franciosa JA (1984) Relation of right ventricular ejection fraction to exercise capacity in chronic left ventricular failure. Am J Cardiol 54: 596–599
Sullivan MJ, Higginbotham MR, Cobb FR (1988) Exercise training in patients with severe left ventricular dysfunction. Hemodynamic and metabolic effects. Circulation 78: 506–515
Giordano A, Giannuzzi P, Tavazzi L (1988) Feasibility of physical training in post-infarct patients with left ventricular aneurysm: a haemodynamic study. Eur Heart J 9 (Suppl F): 11–15
Cobb FR, Williams RS, McEwan P, Jones RH, Coleman RE, Wallace AG (1982) Effects of exercise training on ventricular function in patients with recent myocardial infarction. Circulation 66: 100–108
Shen WF, Roubin GS, Hirasawa K, Choong C Y-P, Hutton BF, Harris PJ, Fletcher PJ, Kelly DT (1985) Left ventricular volume and ejection fraction response to exercise in chronic heart failure: differences between dilated cardiomyopathy and previous myocardial infarction. Am J Cardiol 55: 1027–1031
Jugdutt BI, Michrowski BL, Kappagoda CT (1988) Exercise training after anterior Q wave myocardial infarction: importance of regional left ventricular function and topography. J Am Coll Cardiol 12: 362–372
Iskandrian AS (1988) Exercise training after anterior Q wave myocardial infarction: harmful or beneficial. J Am Coll Cardiol 12: 373–374
Leier CV, Huss P, Magorien RD, Unverferth DV (1983) Improved exercise capacity and differing arterial and venous tolerance during chronic isosorbide dinitrate therapy for congestive heart failure. Circulation 67: 817–822
Franciosa JA, Wilen MM, Jordan RA (1985) Effects of enalapril, a new angiotensin-converting enzyme inhibitor, in a controlled trial in heart failure. J Am Coll Cardiol 5: 101–107
Captopril Multicenter Research Group (1983) A placebo-controlled trial of captopril in refractory chronic congestive heart failure. J Am Coll Cardiol 2: 755–763
Lipkin DT, Poole-Wilson PA (1985) Treatment of chronic heart failure. A review of recent drug trials. Br Med J 291: 993–996
Tan LB (1987) Clinical and research implications of new concepts in the assessment of cardiac pumping performance in heart failure. Cardiovasc Res 21: 615–622
Wilson JR (1987) Exercise and the failing heart. Cardiol Clin 5: 171–181
Tristani FE, Hughes CV, Archibald DG, Sheldahl JM, Cohn JN, Fletcher R (1987) Safety of graded symptom-limited exercise testing in patients with congestive heart failure. Circulation 76 (Suppl VI):VI-54-VI-58
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© 1991 Springer-Verlag Berlin Heidelberg
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Wenger, N.K. (1991). Exercise Testing and Training of Patients with Congestive Heart Failure and Left Ventricular Dysfunction. In: Lewis, B.S., Kimchi, A. (eds) Heart Failure Mechanisms and Management. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-58231-8_38
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DOI: https://doi.org/10.1007/978-3-642-58231-8_38
Publisher Name: Springer, Berlin, Heidelberg
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