Exercise training in older patients with systolic heart failure: adherence, exercise capacity, inflammation and glycemic control.
OBJECTIVE
Training improves exercise capacity in patients with heart failure (CHF) but most evidence is on selected younger patients with systolic CHF.


METHODS
All patients diagnosed with CHF over 3 years were screened for inclusion and exclusion criteria. Fifty two patients with systolic CHF (LVEF<45, NYHA II-III) received supervised exercise training twice weekly for 8 weeks.


RESULTS
Mean age was 68.2 (+/-SD 11.3) years. Despite marked improvements in physical fitness (workload, 6 minute walk test, incremental shuttle walk test and sit to stand test), there were no changes in serological markers of glycemic control (glucose, insulin, glycerol, free fatty acids, HbA1c), inflammation and endothelial function (hsCRP, orosomucoid, interleukin 6, TNF-alpha, urine-orosomucoid and -albumin/creatinin), lipid metabolism, NT-proBNP or other regulatory hormones (cortisol, epinephrine and IGF-1). There were no changes in quality of life.


CONCLUSIONS
The effect of exercise training in these older CHF-patients was not as impressive as reported in younger and more selected patients. More studies on the efficiency of exercise training that reflect the age- and co-morbidity of the majority of CHF-patients are needed.
Prescott
Eva
E
Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark.
Hjardem-Hansen
Rasmus
R
Dela
Flemming
F
Teisner
Ane S
AS
Nielsen
Henrik
H
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D004730:Endothelium, Vascular / Q000378:metabolism; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005240:Feasibility Studies; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D054143:Heart Failure, Systolic / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D018836:Inflammation Mediators / Q000097:blood*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D013997:Time Factors; D016896:Treatment Outcome
D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D018836:Inflammation Mediators; D007328:Insulin; C517652:hemoglobin A1c protein, human