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Research Paper|Volume 8, Issue 5|pp 860—872

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

Roberto Antonicelli1, Liana Spazzafumo2, Simonetta Scalvini3, Fabiola Olivieri4,5, Maria Vittoria Matassini6, Gianfranco Parati7,8, Donatella Del Sindaco9, Raffaella Gallo10, Fabrizia Lattanzio11
  • 1Department of Cardiology, INRCA-IRCCS National Institute, Ancona, Italy
  • 2Biostatistics Centre, INRCA-IRCCS National Institute, Ancona, Italy
  • 3Department of Cardiology, Maugeri Foundation IRCCS, Lumezzane (BS), Italy
  • 4Department of Clinical and Molecular Sciences, DISCLIMO, Università Politecnica delle Marche, Ancona, Italy
  • 5Center of Clinical Pathology and Innovative Therapy, INRCA-IRCCS National Institute, Ancona, Italy
  • 6Clinic of Cardiology, Università Politecnica delle Marche, Ancona, Italy
  • 7Department of Cardiovascular, Neural and Metabolic Sciences, S. Luca Hospital, Italian Auxology Institute, Milano, Italy
  • 8Department of Health Sciences, University of Milano-Bicocca, Milan, Italy
  • 9Department of Cardiology, INRCA-IRCCS National Institute, Roma, Italy
  • 10Department of Cardiology, INRCA-IRCCS National Institute, Cosenza, Italy
  • 11Scientific Direction, INRCA-IRCCS National Institute, Ancona, Italy

* * Equal contribution

Received: January 15, 2016Accepted: January 30, 2016Published: March 4, 2016
https://doi.org/10.18632/aging.100901

Copyright: © 2016 Antonicelli et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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.