Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:


Exercise improves quality of life for heart failure patients

Heart failure patients who regularly exercise fare better and feel better about their lives than do similar patients who do not work out on a regular basis, say researchers at Duke University Medical Center.

The findings, reported in the April 8 issue of the Journal of the American Medical Association, go a long way toward addressing concerns about the value of exercise for the nation's five million patients with heart failure. They also raise important policy questions for the country's Medicare program and other insurers.

"Past studies have sent mixed signals about the merit of exercise for patients with heart failure. The HF-ACTION study (A Controlled Trial Investigating Outcomes Exercise Training) shows that exercise is not only safe for patients, but also helps to improve the quality of their lives, overall," says Kathryn Flynn, Ph.D., a health services researcher at the Duke Clinical Research Institute (DCRI) and lead author of the study.

HF-ACTION is the largest clinical trial to date examining the value of exercise in the treatment of heart failure. Investigators enrolled 2331 patients with moderate to severe heart failure at 82 sites throughout the U.S., Canada and France from 2003 to 2008.

Funded by a $37 million grant from the National Heart, Blood, and Lung Institute, researchers randomized participants to receive either standard care or standard care plus an exercise program. The exercise regimen consisted of three months of supervised aerobic training on a bicycle or treadmill, followed by instruction for continued home-based training. Researchers set the exercise goal at five, 40-minute workouts, or 200 minutes of exercise per week. Participants reached about 60 percent of that goal at one year.

Participants had significant heart failure upon entering the study, measured by diminished left ventricular ejection fraction (mean, 25 percent). Ninety-five per cent of the patients were taking medications for heart failure, such as ACE-inhibitors or beta-blockers, and 40 percent were using mechanical devices to boost their hearts' ability to pump or to treat arrhythmias. The average age of the patients was 59; 28 percent were women.

Upon enrollment, patients filled out the Kansas City Cardiomyopathy Questionnaire (KCCQ), a 23-item measure shown to be responsive to underlying clinical changes in patients with heart failure. The KCCQ generated an overall measure of quality of life and subscale measures reflecting the patients' physical limitations, symptoms, quality of life and social restrictions. Participants completed the questionnaire at three-month intervals for the first 12 months, and annually thereafter. The average time of follow-up was two and one-half years. There were no significant differences between the two patient groups at baseline. The average overall KCCQ score among patients in both groups was 66.

At three months, patients in both groups showed improvement, with patients in the usual care group registering an average three-point gain on the KCCQ score and those in the exercise group showing an average five-point gain (p
Researchers also looked at how individual patients responded to exercise training and found that a higher percentage of those in the exercise group experienced clinical meaningful improvement. At three months, 54 percent of those in the exercise group saw a five-point gain in overall KCCQ score, while only 28 percent of those in the usual care group met that goal. (p

Exercise group members consistently outscored those in the usual care group on all subscale measures on the KCCQ, as well. "And the best news is that while the gains were modest, they were sustained over time," says Flynn.

During the study period, the incidence of adverse effects was similar between the two groups. There were 41 heart attacks among patients in the exercise arm and 45 heart attacks among those receiving usual care. Arrhythmias occurred in about 14 percent of the patients in each group.

Researchers say the findings are important because they demonstrate that a relatively low-cost and readily available intervention can significantly improve the quality of life for heart failure patients, a finding that may be important for the country's Medicare program, which currently does not pay for exercise therapy for patients with heart failure.

"We found that a majority of those who exercised reported a five-point improvement in the KCCQ scale. That means that they experienced significant improvement in many aspects of their day-to-day activities, such as working, walking, being able to dress, bathe, and getting out to visit family and friends," says Ileana Piña, MD, a professor of medicine at Case Western Reserve University and chair of the HF-ACTION Steering Committee. Piña, who is a Quality Scholar at the Cleveland VA, says clinicians should consider using the KCCQ inventory on a regular basis. "It is a quick and easy method to find out valuable information about patients' health status. It only takes about eight minutes to fill out, which is a small burden for patients."

"This study has important implications for the five million Americans who have heart failure," noted Elizabeth G. Nabel, MD, NHLBI director. "As the number of people affected by heart failure is expected to rise with the aging U.S. population, it is promising to know that regular aerobic activity can not only help patients extend their lives, but exercise can also positively impact their everyday activities and outlook."

Additional authors on the study include senior author, Kevin Weinfurt, DCRI, Steven Keteyian, co-chair of the HF-ACTION Steering Committee, Henry Ford Hospital; Christopher O'Connor, Kevin Schulman, Li Lin, James Blumenthal, Stephen Ellis, and William Kraus, from DCRI; David Whellan, Jefferson Medical College; Nancy Houston Miller, Stanford University; Jonathan Howlett, Dalhousie University; Dalane Kitzman, Wake Forest University, John Spertus, Mid America Heart Institute; and Lawrence Fine, National Heart, Lung, and Blood Institute.

Michelle Gailiun | EurekAlert!
Further information:

More articles from Health and Medicine:

nachricht NIH scientists describe potential antibody treatment for multidrug-resistant K. pneumoniae
14.03.2018 | NIH/National Institute of Allergy and Infectious Diseases

nachricht Researchers identify key step in viral replication
13.03.2018 | University of Pittsburgh Schools of the Health Sciences

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Locomotion control with photopigments

Researchers from Göttingen University discover additional function of opsins

Animal photoreceptors capture light with photopigments. Researchers from the University of Göttingen have now discovered that these photopigments fulfill an...

Im Focus: Surveying the Arctic: Tracking down carbon particles

Researchers embark on aerial campaign over Northeast Greenland

On 15 March, the AWI research aeroplane Polar 5 will depart for Greenland. Concentrating on the furthest northeast region of the island, an international team...

Im Focus: Unique Insights into the Antarctic Ice Shelf System

Data collected on ocean-ice interactions in the little-researched regions of the far south

The world’s second-largest ice shelf was the destination for a Polarstern expedition that ended in Punta Arenas, Chile on 14th March 2018. Oceanographers from...

Im Focus: ILA 2018: Laser alternative to hexavalent chromium coating

At the 2018 ILA Berlin Air Show from April 25–29, the Fraunhofer Institute for Laser Technology ILT is showcasing extreme high-speed Laser Material Deposition (EHLA): A video documents how for metal components that are highly loaded, EHLA has already proved itself as an alternative to hard chrome plating, which is now allowed only under special conditions.

When the EU restricted the use of hexavalent chromium compounds to special applications requiring authorization, the move prompted a rethink in the surface...

Im Focus: Radar for navigation support from autonomous flying drones

At the ILA Berlin, hall 4, booth 202, Fraunhofer FHR will present two radar sensors for navigation support of drones. The sensors are valuable components in the implementation of autonomous flying drones: they function as obstacle detectors to prevent collisions. Radar sensors also operate reliably in restricted visibility, e.g. in foggy or dusty conditions. Due to their ability to measure distances with high precision, the radar sensors can also be used as altimeters when other sources of information such as barometers or GPS are not available or cannot operate optimally.

Drones play an increasingly important role in the area of logistics and services. Well-known logistic companies place great hope in these compact, aerial...

All Focus news of the innovation-report >>>



Industry & Economy
Event News

Ultrafast Wireless and Chip Design at the DATE Conference in Dresden

16.03.2018 | Event News

International Tinnitus Conference of the Tinnitus Research Initiative in Regensburg

13.03.2018 | Event News

International Virtual Reality Conference “IEEE VR 2018” comes to Reutlingen, Germany

08.03.2018 | Event News

Latest News

Wandering greenhouse gas

16.03.2018 | Earth Sciences

'Frequency combs' ID chemicals within the mid-infrared spectral region

16.03.2018 | Physics and Astronomy

Biologists unravel another mystery of what makes DNA go 'loopy'

16.03.2018 | Life Sciences

Science & Research
Overview of more VideoLinks >>>