Effects of exercise training in patients with heart failure: the Exercise Rehabilitation Trial (EXERT).
BACKGROUND
The purpose of this study was to examine the effects of exercise training on functional capacity in patients with heart failure.


METHODS
One hundred eighty-one patients in New York Heart Association class I to III, with ejection fraction <40% and 6-minute walk distance <500 meters, were recruited into a randomized, controlled, single-blind trial comparing 3 months of supervised training, then 9 months of home-based training with usual care.


RESULTS
There was a significant increase in 6-minute walk distance at 3 and 12 months but no between-group differences. Incremental peak oxygen uptake increased in the exercise group compared with the control group at 3 months (0.104 +/- 0.026 L/min vs 0.025 +/- 0.023 L/min; P =.026) and 12 months (0.154 +/- 0.074 L/min vs 0.024 +/- 0.027 L/min; P =.081). Compared with the control group, significant increases were observed in the exercise group for arm and leg strength. No significant changes were observed in cardiac function or quality of life. Adherence to exercise was good during supervised training but reduced during home-based training.


CONCLUSIONS
Exercise training improves peak oxygen uptake and strength during supervised training. Over the final 9 months of the study, there was little further improvement, suggesting that some supervision is required for these patients. There were no adverse effects on cardiac function or clinical events.
McKelvie
Robert S
RS
Division of Cardiology and Preventive Cardiology and Therapeutic Program, Hamilton Health Sciences Corporation, Hamilton, Ontario, Canada. mckelrob@hhsc.on.ca
Teo
Koon K
KK
Roberts
Robin
R
McCartney
Neil
N
Humen
Dennis
D
Montague
Terence
T
Hendrican
Katie
K
Yusuf
Salim
S
D000368:Aged; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D010349:Patient Compliance; D011788:Quality of Life; D016037:Single-Blind Method; D016138:Walking