title: Exercise: a "new drug" for elderly patients with chronic heart failure.
abstract: Patients with chronic heart failure (CHF) experience progressive deterioration of functional capacity and quality of life (QoL). This prospective, randomized, controlled trial assesses the effect of exercise training (ET) protocol on functional capacity, rehospitalization, and QoL in CHF patients older than 70 years compared with a control group. A total of 343 elderly patients with stable CHF (age, 76.90±5.67, men, 195, 56.9%) were randomized to ET (TCG, n=170) or usual care (UCG, n=173). The ET protocol involved supervised training sessions for 3 months in the hospital followed by home-telemonitored sessions for 3 months. Assessments, performed at baseline and at 3 and 6 months, included: ECG, resting echocardiography, NT-proBNP, 6-minute walk test (6MWT), Minnesota Living with Heart Failure Questionnaire, and comprehensive geriatric assessment with the InterRAI-HC instrument. As compared to UCG, ET patients at 6 months showed: i) significantly increased 6MWT distance (450±83 vs. 290±97 m, p=0.001); ii) increased ADL scores (5.00±2.49 vs. 6.94±5.66, p=0.037); iii) 40% reduced risk of rehospitalisation (hazard ratio=0.558, 95%CI, 0.326-0.954, p=0.033); and iv) significantly improved perceived QoL (28.6±12.3 vs. 44.5±12.3, p=0.001). In hospital and home-based telemonitored exercise confer significant benefits on the oldest CHF patients, improving functional capacity and subjective QoL and reducing risk of rehospitalisation.
authors.affiliation: Department of Cardiology, INRCA-IRCCS National Institute, Ancona, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Antonicelli
authors.affiliation: Biostatistics Centre, INRCA-IRCCS National Institute, Ancona, Italy.
authors.forename: Liana
authors.initials: L
authors.lastname: Spazzafumo
authors.affiliation: Department of Cardiology, Maugeri Foundation IRCCS, Lumezzane (BS), Italy.
authors.forename: Simonetta
authors.initials: S
authors.lastname: Scalvini
authors.affiliation: Department of Clinical and Molecular Sciences, DISCLIMO, Università Politecnica delle Marche, Ancona, Italy.|Center of Clinical Pathology and Innovative Therapy, INRCA-IRCCS National Institute, Ancona, Italy.
authors.forename: Fabiola
authors.initials: F
authors.lastname: Olivieri
authors.affiliation: Clinic of Cardiology, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Maria Vittoria
authors.initials: MV
authors.lastname: Matassini
authors.affiliation: Department of Cardiovascular, Neural and Metabolic Sciences, S. Luca Hospital, Italian Auxology Institute, Milan, Italy.|Department of Health Sciences, University of Milano-Bicocca, Milan, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Parati
authors.affiliation: Department of Cardiology, INRCA-IRCCS National Institute, Roma, Italy.
authors.forename: Donatella
authors.initials: D
authors.lastname: Del Sindaco
authors.affiliation: Department of Cardiology, INRCA-IRCCS National Institute, Cosenza, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Gallo
authors.affiliation: Scientific Direction, INRCA-IRCCS National Institute, Ancona, Italy.
authors.forename: Fabrizia
authors.initials: F
authors.lastname: Lattanzio
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D004562:Electrocardiography; D015444:Exercise; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D015577:Geriatric Assessment; D006333:Heart Failure / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: 6MWT; QoL; chronic heart failure; elderly CHF patients; physical exercise; quality of life