title: Exercise training improves neurovascular control and functional capacity in heart failure patients regardless of age.
abstract: BACKGROUND
  Exercise training is a non-pharmacological strategy for treatment of heart failure. Exercise training improves functional capacity and quality of life in patients. Moreover, exercise training reduces muscle sympathetic nerve activity (MSNA) and peripheral vasoconstriction. However, most of these studies have been conducted in middle-aged patients. Thus, the effects of exercise training in older patients are much less understood. The present study was undertaken to investigate whether exercise training improves functional capacity, muscular sympathetic activation and muscular blood flow in older heart failure patients, as it does in middle-aged heart failure patients.
  
  
  METHODS
  Fifty-two consecutive outpatients with heart failure from the database of the Unit of Cardiovascular Rehabilitation and Physiology Exercise were divided by age (middle-aged, defined as 45-59 years, and older, defined as 60-75 years) and exercise status (trained and untrained).
  
  
  METHODS
  MSNA was recorded directly from the peroneal nerve using the microneurography technique. Forearm blood flow (FBF) was measured by venous occlusion plethysmography. Functional capacity was evaluated by cardiopulmonary exercise test.
  
  
  RESULTS
  Exercise training significantly and similarly increased FBF and peak VO(2) in middle-aged and older heart failure patients. In addition, exercise training significantly and similarly reduced MSNA and forearm vascular resistance in these patients. No significant changes were found in untrained patients.
  
  
  CONCLUSIONS
  Exercise training improves neurovascular control and functional capacity in heart failure patients regardless of age.
authors.affiliation: Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Ligia M
authors.initials: LM
authors.lastname: Antunes-Correa
authors.forename: Bianca Y
authors.initials: BY
authors.lastname: Kanamura
authors.forename: Ruth C
authors.initials: RC
authors.lastname: Melo
authors.forename: Thais S
authors.initials: TS
authors.lastname: Nobre
authors.forename: Linda M
authors.initials: LM
authors.lastname: Ueno
authors.forename: Fabio G M
authors.initials: FG
authors.lastname: Franco
authors.forename: Fabiana
authors.initials: F
authors.lastname: Roveda
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Braga
authors.forename: Maria U P B
authors.initials: MU
authors.lastname: Rondon
authors.forename: Patricia C
authors.initials: PC
authors.lastname: Brum
authors.forename: Antonio C P
authors.initials: AC
authors.lastname: Barretto
authors.forename: Holly R
authors.initials: HR
authors.lastname: Middlekauff
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Negrao
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001938:Brazil; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005260:Female; D005542:Forearm; D006333:Heart Failure / Q000503:physiopathology / Q000534:rehabilitation*; D006439:Hemodynamics; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018482:Muscle, Skeletal / Q000098:blood supply* / Q000294:innervation*; D010101:Oxygen Consumption; D010543:Peroneal Nerve / Q000503:physiopathology*; D010991:Plethysmography; D020127:Recovery of Function; D012039:Regional Blood Flow; D016896:Treatment Outcome