Reverse remodelling through exercise training is more pronounced in non-ischemic heart failure

Reverse remodelling through exercise training is more pronounced in non-ischemic heart failure

Purpose Most training studies in patients with chronic heart failure (CHF) do not consider CHF aetiology in the interpretation of the results. About 60% of the patients in those studies have ischemic CHF (IHF) and 40% non-ischemic CHF (NHF). Recently, we conducted a randomized controlled trial to st...

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Bibliographic Details
Published in:Clinical research in cardiology Vol. 97; no. 12; pp. 865 - 871
Main Authors: Delagardelle, Charles MD, Feiereisen, Patrick MSc, Vaillant, Michel PhD, Gilson, Georges PhD, Lasar, Yves MD, Beissel, Jean MD, Wagner, Daniel R. MD, PhD
Format: Journal Article
Language:English
Published: Dordrecht Dordrecht : D. Steinkopff-Verlag 01-12-2008
D. Steinkopff-Verlag
Springer Nature B.V
Subjects:
Aged
Cardiology
Clinical trials
Drug therapy
Echocardiography - methods
Exercise Therapy - methods
Female
Heart failure
Heart Failure - physiopathology
Heart Failure - therapy
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Myocardial Ischemia - physiopathology
Myocardial Ischemia - therapy
Original Paper
Oxygen Consumption
Radionuclide Ventriculography - methods
Ventricular Dysfunction, Left - therapy
Ventricular Remodeling
CHF
ischemic and non-ischemic aetiology
training
LV remodeling
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Summary:Purpose Most training studies in patients with chronic heart failure (CHF) do not consider CHF aetiology in the interpretation of the results. About 60% of the patients in those studies have ischemic CHF (IHF) and 40% non-ischemic CHF (NHF). Recently, we conducted a randomized controlled trial to study three different training modalities in 60 patients with severe CHF, with a similar distribution of IHF and NHF patients. In the present post hoc analysis we compared the differences in training results between ischemic and non-ischemic patients. Methods Left ventricular ejection fraction (EF), end diastolic volume (EDV), end systolic volume (ESV), measured with radionuclide ventriculography (RNV) and echocardiography, NT-pro BNP, peak oxygen uptake (peak [graphic removed] ), working capacity and muscular volume were analyzed before and after training in 45 patients training for 40 sessions, 3 times per week. Fifteen patients served as control group. The outcome was analyzed considering the aetiology of CHF, either ischemic or non-ischemic. Results There were no significant differences in improvements of peak [graphic removed] , working capacity and muscular volume between IHF and NHF patients. In NHF patients, EF increased while EDV and ESV decreased after training. These parameters remained unchanged in IHF patients after training. NT-pro BNP decreased significantly in NHF patients and increased in IHF patients after training. In the control group, patients showed a mild improvement of EF and a decrease of NT-pro BNP. Conclusion This post hoc analysis shows that training intervention is associated with significant reverse remodelling in NHF, but not in IHF patients, whereas [graphic removed] peak and muscle volume improve regardless of CHF aetiology. Future prospective studies are needed to confirm our findings.
Bibliography:http://dx.doi.org/10.1007/s00392-008-0698-x
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ISSN:1861-0684
1861-0692
DOI:10.1007/s00392-008-0698-x