title: Acupuncture improves exercise tolerance of patients with heart failure: a placebo-controlled pilot study.
abstract: BACKGROUND
  Congestive heart failure (CHF) is a complex clinical syndrome with autonomic dysbalance and increased plasma levels of inflammatory cytokines, which further worsen the syndrome. Experimental data have shown that stimulation of certain acupoints decreases autonomic dysbalance.
  
  
  OBJECTIVE
  To test the therapeutic potential of acupuncture for life-threatening diseases such as CHF.
  
  
  METHODS
  17 stable patients with CHF (New York Heart Association class II-III, ejection fraction <40%) receiving optimised heart failure medication were randomised into a verum acupuncture (VA) and placebo acupuncture (PA) group. Cardiopulmonary function, heart rate variability and quality of life were explored.
  
  
  RESULTS
  No improvements of the cardiac ejection fraction or peak oxygen uptake were observed, but the ambulated 6 min walk distance was remarkably increased in the VA group (+32+/-7 m) but not the PA group (-1+/-11 m; p<0.01). Accordingly, post-exercise recovery after maximal exercise and the VE/VCO(2) slope, a marker of ventilatory efficiency, were improved after VA but not PA. Furthermore, heart rate variability increased after VA, but decreased after PA. The 'general health' score and 'body pain' score of the quality-of-life questionnaire SF-36 tended to be improved after VA.
  
  
  CONCLUSIONS
  Acupuncture may become an additional therapeutic strategy to improve the exercise tolerance of patients with CHF, potentially by improving skeletal muscle function.
authors.affiliation: Department of Cardiology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Arnt V
authors.initials: AV
authors.lastname: Kristen
authors.forename: Boris
authors.initials: B
authors.lastname: Schuhmacher
authors.forename: Kathrin
authors.initials: K
authors.lastname: Strych
authors.forename: Dirk
authors.initials: D
authors.lastname: Lossnitzer
authors.forename: Hans-Christoph
authors.initials: HC
authors.lastname: Friederich
authors.forename: Thomas
authors.initials: T
authors.lastname: Hilbel
authors.forename: Markus
authors.initials: M
authors.lastname: Haass
authors.forename: Hugo A
authors.initials: HA
authors.lastname: Katus
authors.forename: Antonius
authors.initials: A
authors.lastname: Schneider
authors.forename: Konrad M
authors.initials: KM
authors.lastname: Streitberger
authors.forename: Johannes
authors.initials: J
authors.lastname: Backs
mesh_terms: D015670:Acupuncture Therapy / Q000379:methods*; D000368:Aged; D001341:Autonomic Nervous System / Q000503:physiopathology; D016207:Cytokines / Q000097:blood; D005080:Exercise Test / Q000379:methods; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D006333:Heart Failure / Q000503:physiopathology / Q000628:therapy*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D016037:Single-Blind Method; D016896:Treatment Outcome
chemical_list: D016207:Cytokines; D018836:Inflammation Mediators