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Randomized Controlled Trial
. 2016 May;8(5):860-72.
doi: 10.18632/aging.100901.

Exercise: a "new drug" for elderly patients with chronic heart failure

Roberto Antonicelli  1 , Liana Spazzafumo  2 , Simonetta Scalvini  3 , Fabiola Olivieri  4   5 , Maria Vittoria Matassini  6 , Gianfranco Parati  7   8 , Donatella Del Sindaco  9 , Raffaella Gallo  10 , Fabrizia Lattanzio  11
Affiliations
Randomized Controlled Trial

Exercise: a "new drug" for elderly patients with chronic heart failure

Roberto Antonicelli et al. Aging (Albany NY). 2016 May.

Abstract

Patients with chronic heart failure (CHF) experience progressive deterioration of functional capacity and quality of life (QoL). This prospective, randomized, controlled trial assesses the effect of exercise training (ET) protocol on functional capacity, rehospitalization, and QoL in CHF patients older than 70 years compared with a control group. A total of 343 elderly patients with stable CHF (age, 76.90±5.67, men, 195, 56.9%) were randomized to ET (TCG, n=170) or usual care (UCG, n=173). The ET protocol involved supervised training sessions for 3 months in the hospital followed by home-telemonitored sessions for 3 months. Assessments, performed at baseline and at 3 and 6 months, included: ECG, resting echocardiography, NT-proBNP, 6-minute walk test (6MWT), Minnesota Living with Heart Failure Questionnaire, and comprehensive geriatric assessment with the InterRAI-HC instrument. As compared to UCG, ET patients at 6 months showed: i) significantly increased 6MWT distance (450±83 vs. 290±97 m, p=0.001); ii) increased ADL scores (5.00±2.49 vs. 6.94±5.66, p=0.037); iii) 40% reduced risk of rehospitalisation (hazard ratio=0.558, 95%CI, 0.326-0.954, p=0.033); and iv) significantly improved perceived QoL (28.6±12.3 vs. 44.5±12.3, p=0.001). In hospital and home-based telemonitored exercise confer significant benefits on the oldest CHF patients, improving functional capacity and subjective QoL and reducing risk of rehospitalisation.

Keywords: 6MWT; QoL; chronic heart failure; elderly CHF patients; physical exercise; quality of life.

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Conflict of interest statement

Conflict of interest statement

The authors have no conflict of interests to declare.

Figures

Figure 1
Figure 1
The flow of the 426 consecutive CHF patients enrolled for the study. TCG=training care group; UCG=usual care group.
Figure 2a
Figure 2a. Effect of exercise training and usual care on rehospitalization
Cox model adjusted for age, gender, BMI, 6MWT distance, ADL, IADL, and QoL score. TCG=training care group; UCG=usual care group.
Figure 2b
Figure 2b. Effect of usual care and exercise training on rehospitalization
Decision-tree analysis developed by CHAID (Chi-squared Automatic Interaction Detector) to assess the risk of rehospitalization including dichotomized variables such as age, gender, BMI, 6MWT distance, ADL, IADL and QoL score as predictors. TCG=training care group; UCG=usual care group. P value adj. = p-value of the chi-square test, adjusted by Bonferroni's correction. DF = degree of freedom.
See this image and copyright information in PMC

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