Jill Downing|Gary J. Balady
The Role of Exercise Training in Heart Failure
Boston Medical Center|Boston University|Boston Medical Center|Boston University
exercise training patients systolic heart failure hf accepted adjunct evidencebased management program review describes pathophysiologic features thought responsible exercise intolerance experienced hf patient significant research expanded appreciation interplay hemodynamic ventilatory skeletal myopathic processes common chronic condition randomized controlled exercise trials designed measure endothelial function inflammatory markers sympathetic neural activation skeletal muscle metabolism structure defined pathophysiology documented impact exercise training processes confirmed benefit therapy consistent prior clinical research patient experience recently published results hfaction heart failurea controlled trial investigating outcomes exercise training demonstrated modest improvement exercise capacity reduction symptoms improved selfreported measures quality life without adverse events consideration given review benefits variable intensity programs addition resistance exercise standard aerobic prescription despite increasing validation role exercise training plays modification exercise intolerance challenges remain routine therapeutic application including acceptance use adjunctive intervention management patient hf limited insurance coverage hf patients cardiac rehabilitation tailoring exercise programs best address needs subgroups patients improved short longterm adherence exercise training physically active lifestyle