scholarly journals Cardiac Rehabilitation in Patients with Heart Failure: New Perspectives in Exercise Training

2016 ◽  
Vol 2 (1) ◽  
pp. 63 ◽  
Author(s):  
Maurizio Volterrani ◽  
Ferdinando Iellamo ◽  
◽  
◽  
Keyword(s):  
Heart Failure ◽  
Exercise Training ◽  
Interval Training ◽  
Aerobic Exercise Training ◽  
Reduced Ejection Fraction ◽  
Class 1 ◽  
Exercise Dose ◽  
Intensity Of Exercise ◽  
The Individual ◽  
Training Exercises

Exercise training is recommended to patients with chronic heart failure (CHF) and reduced ejection fraction at a class 1 evidence level. Currently the ‘dose’ of exercise (dose being both volume and intensity) still remains uncertain and the best form of aerobic exercise training has not been defined. Guidelines commonly use heart rate (HR) as a target factor for both moderate continuous and interval training exercises. However, exercise training guided by HR can be limited in CHF patients due to chronotropic incompetence and beta-blocker treatment. In our study, we systematically addressed the above issues by applying a training method that takes into account both the volume and intensity of exercise on an individual basis. This method is referred to as individual TRaining IMPulses (TRIMPi). In this review, we summarise a series of investigations that used TRIMPi and different exercise forms to quantify the optimum training load in CHF patients. This review also highlights the way TRIMPi and the individual exercise dose affects cardiorespiratory, metabolic and autonomic cardiac adaptations.

scholarly journals Exercise Training in Heart Failure Patients With Persistent Atrial Fibrillation: a Practical Approach

2018 ◽  
Vol 4 (2) ◽  
pp. 107 ◽  
Author(s):  
Justien Cornelis ◽  
Jonathan Myers ◽  
◽  
◽  
Keyword(s):  
Heart Failure ◽  
Exercise Training ◽  
Persistent Atrial Fibrillation ◽  
Training Programme ◽  
Cardiopulmonary Exercise Test ◽  
Aerobic Exercise Training ◽  
Exercise Programmes ◽  
Training Programmes ◽  
Training Modalities

Persistent AF is present in at least 20 % of patients with chronic heart failure (CHF) and is related to a poor prognosis and more severe cardiac arrhythmias. CHF and AF share a common pathophysiology and can exacerbate one another. Exercise programmes for people with CHF have been shown to improve aerobic capacity, prognosis and quality of life. Given that patients with both CHF and AF show greater impairment in exercise performance, exercise training programmes have the potential to be highly beneficial. Optimal clinical evaluation using a cardiopulmonary exercise test should be performed before starting a training programme. Heart rate should be calculated over a longer period of time In patients with CHF and AF than those in sinus rhythm. The use of telemetry is advised to measure HR accurately during training. If telemetry is not available, patients can be safely trained based on the concomitant workload. An aerobic exercise training programme of moderate to high intensity, whether or not combined with strength training, is advised in patients with CHF and AF. Optimal training modalities and their intensity require further investigation.

scholarly journals Targeting Endothelial Function to Treat Heart Failure with Preserved Ejection Fraction: The Promise of Exercise Training

2017 ◽  
Vol 2017 ◽  
pp. 1-17 ◽  
Author(s):  
Andreas B. Gevaert ◽  
Katrien Lemmens ◽  
Christiaan J. Vrints ◽  
Emeline M. Van Craenenbroeck
Keyword(s):  
Heart Failure ◽  
Endothelial Dysfunction ◽  
Exercise Training ◽  
Ejection Fraction ◽  
Current Knowledge ◽  
Beta Blockers ◽  
Preserved Ejection Fraction ◽  
Cellular Mechanisms ◽  
Converting Enzyme Inhibitors ◽  
Reduced Ejection Fraction

Although the burden of heart failure with preserved ejection fraction (HFpEF) is increasing, there is no therapy available that improves prognosis. Clinical trials using beta blockers and angiotensin converting enzyme inhibitors, cardiac-targeting drugs that reduce mortality in heart failure with reduced ejection fraction (HFrEF), have had disappointing results in HFpEF patients. A new “whole-systems” approach has been proposed for designing future HFpEF therapies, moving focus from the cardiomyocyte to the endothelium. Indeed, dysfunction of endothelial cells throughout the entire cardiovascular system is suggested as a central mechanism in HFpEF pathophysiology. The objective of this review is to provide an overview of current knowledge regarding endothelial dysfunction in HFpEF. We discuss the molecular and cellular mechanisms leading to endothelial dysfunction and the extent, presence, and prognostic importance of clinical endothelial dysfunction in different vascular beds. We also consider implications towards exercise training, a promising therapy targeting system-wide endothelial dysfunction in HFpEF.

scholarly journals Nordic Walking May Safely Increase the Intensity of Exercise Training in Healthy Subjects and in Patients with Chronic Heart Failure

2016 ◽  
Vol 25 (1) ◽  
pp. 145-149 ◽  
Author(s):  
Andrzej Lejczak ◽  
Krystian Josiak ◽  
Kinga Węgrzynowska - Teodorczyk ◽  
Eliza Rudzińska ◽  
Ewa Jankowska ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Exercise Training ◽  
Healthy Subjects ◽  
Nordic Walking ◽  
Intensity Of Exercise

scholarly journals Clinical Utility of Exercise Training in Heart Failure with Reduced and Preserved Ejection Fraction

2015 ◽  
Vol 9 ◽  
pp. CMC.S21372 ◽  
Author(s):  
Muhammad Asrar Ul Haq ◽  
Cheng Yee Goh ◽  
Itamar Levinger ◽  
Chiew Wong ◽  
David L. Hare
Keyword(s):  
Heart Failure ◽  
Exercise Training ◽  
Ejection Fraction ◽  
Exercise Tolerance ◽  
Exercise Intolerance ◽  
Sufficient Evidence ◽  
Preserved Ejection Fraction ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure

Reduced exercise tolerance is an independent predictor of hospital readmission and mortality in patients with heart failure (HF). Exercise training for HF patients is well established as an adjunct therapy, and there is sufficient evidence to support the favorable role of exercise training programs for HF patients over and above the optimal medical therapy. Some of the documented benefits include improved functional capacity, quality of life (QoL), fatigue, and dyspnea. Major trials to assess exercise training in HF have, however, focused on heart failure with reduced ejection fraction (HFREF). At least half of the patients presenting with HF have heart failure with preserved ejection fraction (HFPEF) and experience similar symptoms of exercise intolerance, dyspnea, and early fatigue, and similar mortality risk and rehospitalization rates. The role of exercise training in the management of HFPEF remains less clear. This article provides a brief overview of pathophysiology of reduced exercise tolerance in HFREF and heart failure with preserved ejection fraction (HFPEF), and summarizes the evidence and mechanisms by which exercise training can improve symptoms and HF. Clinical and practical aspects of exercise training prescription are also discussed.

scholarly journals Response to Endurance Exercise Training in Older Adults with Heart Failure with Preserved or Reduced Ejection Fraction

2017 ◽  
Vol 65 (8) ◽  
pp. 1698-1704 ◽  
Author(s):  
Ambarish Pandey ◽  
Dalane W. Kitzman ◽  
Peter Brubaker ◽  
Mark J. Haykowsky ◽  
Timothy Morgan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Older Adults ◽  
Exercise Training ◽  
Ejection Fraction ◽  
Endurance Exercise ◽  
Reduced Ejection Fraction ◽  
Endurance Exercise Training
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