[Favourable effects of cardiovascular rehabilitation on funcional capacity and autonomic balance in elderly patients with heart failure].
In 42 patients with chronic heart failure we evaluated left ventricular function, exercise capability and autonomic control before and 3 months after a program of cardiovascular rehabilitation. The results were analyzed separately for younger (Group 1, n=18, age 51 +/- 6 years) and older patients (Group 2, n=24, age 68 +/- 4 years), with comparable clinical characteristics and therapy. Before rehabilitation, compared to younger patients, Group 2 patients showed a lower exercise capability, a comparable left ventricular ejection fraction and similar high sympathetic activity at rest, with no response to regular breathing (= stimulation of cardiopulmonary receptors, i.e. parasympathetic challenge) and active standing (= sympathetic stimulation). After rehabilitation, in both groups a 20% improvement of exercise tolerance and aerobic performance was observed, as well as a slightly increase of left ventricular ejection fraction (about 10%), and a recovery in vagal and sympathetic responsiveness. Thus, in heart failure patients age does not hinder the favorable clinical and autonomic modulation induced by cardiovascular rehabilitation.
Malfatto
Gabriella
G
Divisione di Riabilitazione Cardiologica, Istituto Scientifico Ospedale San Luca, Istituto Auxologico Italiano IRCCS, Milano, Italy. malfi@auxologico.it
Branzi
Giovanna
G
Bizzi
Caterina
C
Valli
Paola
P
Facchini
Mario
M
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015308:Anaerobic Threshold; D000704:Analysis of Variance; D001341:Autonomic Nervous System / Q000502:physiology; D015444:Exercise; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005260:Female; D006333:Heart Failure / Q000503:physiopathology / Q000534:rehabilitation*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology