title: Outcome of exercise training on the long-term burden of hospitalisation in patients with chronic heart failure. A retrospective study.
abstract: OBJECTIVE
  Heart failure is a major cause of hospitalisation, particularly in patients more than 65 years of age in the western world. A common endpoint in studies designed to evaluate treatment effects in heart failure is mortality and morbidity, often reported as an event of hospitalisation. It has recently been reported that this endpoint is misleading with respect to the burden of the disease with regard to the patient, the health service and costs. Furthermore, it can be hypothesized that different treatment effects are better evaluated using more sensitive parameters than those traditionally used in clinical studies. Short-term beneficial effects of exercise training in heart failure patients have previously been showed. Therefore, the aim of this study was to evaluate the long-term effects of exercise training in heart failure patients with regard to different outcome parameters. METHOD AND STUDY GROUP: Patients with chronic heart failure, stabilised on pharmacological treatment, who had participated in a physical training program for 8 weeks, were analysed retrospectively after 5 years. The study group was compared to a matched control group which received conventional treatment and was diagnosed during the same period but not participating in a training program.
  
  
  RESULTS
  Exercise training in heart failure patients resulted in significantly less hospitalisation events (2+/-3 vs. 3+/-3, p<0.05) and hospitalisation days (10+/-17 vs. 20+/-27, p<0.05) due to cardiac problems at 5 years after follow-up. Exercise training did not effect mortality.
  
  
  CONCLUSIONS
  Long-term effects of exercise training on burden of disease in chronic heart failure patients is associated with significantly less events and days of hospitalisation due to worsening of cardiac disease.
authors.affiliation: Department of Cardiology, Karolinska Institute, Huddinge University Hospital, M52, SE-141 86 Stockholm, Sweden. inger.hagerman@hs.se
authors.forename: I
authors.initials: I
authors.lastname: Hagerman
authors.forename: R
authors.initials: R
authors.lastname: Tyni-Lenné
authors.forename: A
authors.initials: A
authors.lastname: Gordon
mesh_terms: D000368:Aged; D017281:Cost of Illness; D005081:Exercise Therapy; D005260:Female; D006333:Heart Failure / Q000534:rehabilitation*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome