Effect of exercise training on heart failure patients with cardiac resynchronization therapy

Objectives: To determine the effect of exercise training (ET) on exercise capacity and quality of life (QOL), functional class and left ventricular function, following CRT in chronic heart failure (CHF) patients. Methods: We studied 20 patients with CHF who underwent CRT implantation. Patients were randomized into 2 groups: ET Group (n=10) and Control Group (n=10). Supervised ET, was done three times weekly for 4 months; consisting of treadmill walking, breathing exercises, flexibility exercises, stair climbing, and resistance training. Tests of assessment consisted of: treadmill exercise testing, 6-minute walk test (6MWT), breathing tests, multiple repetition maximum (MRM) tests and stair climbing test (SCT). Patients were assessed at baseline and at a 4-month-follow-up. Results: Four months of supervised ET had resulted in significant improvement in QOL with heart failure, in Minnesota Questionnaire by 30% score reduction, compared to 2% increase in the Control Group (p=0.001). Percent-predicted peak oxygen consumption improved in the trained group (p<0.001). Improvements over the Control Group were also found in NYHA class (p=0.013), several echocardiographic parameters (including the ejection fraction), 6MWT (ranges changed from 115.0-237.0 m to 129.0-426.0 m in Exercise Group compared a range change from 103.0-226.0 m to 94.0-320.0 m in the Control Group (p=0.006)), stress test time (a mean increase from 5.98±1.55 min to 10.72±3.94 min in Exercise Group compared to mean increase from 6.07±1.66 min to 6.43±2.84 min in the Control Group) and METs achieved (mean rise from 4.46±0.75 METs to 6.73±1.91 in the Exercise Group ) were found. Moreover, improvements in the SCT, breathing tests (maximum inspiratory pressure and sustained maximal inspiratory pressure), MRM tests (for both upper and lower limbs), and hemodynamic measurements (circulatory power, heart rate recovery time, and systolic blood pressure) were noted compared to the Control Group. Conclusion: Exercise training significantly improves the benefits of CRT. Supervised ET is safe and beneficial for CHF patients with CRT; improving functional class, exercise capacity, QOL, and heart failure symptoms. (Figure Presented).