title: Effects of home-based exercise training on neurovascular control in patients with heart failure.
abstract: BACKGROUND
  The effect of home-based exercise training on neurovascular control in heart failure patients is unknown.
  
  
  OBJECTIVE
  To test the hypothesis that home-based training would maintain the reduction in muscle sympathetic nerve activity (MSNA) and forearm vascular resistance (FVR) acquired after supervised training.
  
  
  RESULTS
  Twenty-nine patients (54+/-1.9 years, EF<40%) were randomised into two groups: untrained control (n=12) and exercise trained (n=17). Both groups underwent assessment of Quality of Life (QoL), MSNA, and forearm blood flow. The exercise group underwent a 4-month supervised training program followed by 4 months of home-based training. After the initial 4 months of training, patients in the exercise group showed a significant increase in peak VO(2) and reduction in MSNA, compared to the untrained group, but this was not maintained during 4 months of home-based training. In contrast, the decrease in FVR (56+/-3 vs. 46+/-4 vs. 40+/-2 U, p=0.008) and the improvement in QOL that were achieved during supervised training were maintained during home-based training.
  
  
  CONCLUSIONS
  Home-based training following supervised training is a safe strategy to maintain improvements in QoL and reduction in FVR in chronic heart failure patients, but is an inadequate strategy to maintain fitness as estimated by peak VO(2) or reduction in neurohumoral activation.
authors.affiliation: Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil. fabio.franco@incor.usp.br
authors.forename: Fábio Gazelato
authors.initials: FG
authors.lastname: de Mello Franco
authors.forename: Amilton C
authors.initials: AC
authors.lastname: Santos
authors.forename: Maria Urbana P
authors.initials: MU
authors.lastname: Rondon
authors.forename: Ivani C
authors.initials: IC
authors.lastname: Trombetta
authors.forename: Célia
authors.initials: C
authors.lastname: Strunz
authors.forename: Ana Maria W
authors.initials: AM
authors.lastname: Braga
authors.forename: Holly
authors.initials: H
authors.lastname: Middlekauff
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Negrão
authors.forename: Antônio C
authors.initials: AC
authors.lastname: Pereira Barretto
mesh_terms: D000328:Adult; D001132:Arm / Q000098:blood supply* / Q000294:innervation*; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy; D005260:Female; D006331:Heart Diseases / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged