title: [Physical training in chronic heart failure: pathophysiology and clinical evolution].
abstract: Chronic heart failure has become one of the main global health problems; 23 million people suffer from this disease worldwide and age of onset has varied considerably over the past five decades, coinciding with other co-morbidities as longevity in the population increases. Treatment of heart failure has also shown striking variations in recent years. Such is the case of the substitution of sympathomimetic drugs by beta-blocking agents, which primarily means a conceptual change in the pathophysiological interpretation of this syndrome. Incorporating to the treatment of heart failure drugs such as angiotensin converting enzyme inhibitors and angiotensin receptor blockers has meant a great step forward in the treatment of patients with this condition that significantly has decreased mortality and morbidity. The latest introduction of the drug identified as angiotensin receptor-neprilysin inhibitor (LCZ696), launched in August 2014 with an even greater reduction in mortality and morbidity of heart failure and fewer side effects, offers a valid hope in the treatment of this pathology. Training and physical activity is another area of treatment being completely reassessed. Pathophysiological aspects that link the practice of systematic physical exercise with heart failure and how they both relate to clinical outcomes, morbidity and mortality in the trained patient are reviewed in this paper.
authors.affiliation: Centro de Rehabilitación del Instituto de Cardiología y Cirugía Cardiovascular, La Habana, Cuba. Address: Calle 17 702, Vedado, La Habana, Cuba. Email: crehab@infomed.sld.cu.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Rivas Estany
authors.affiliation: Centro de Rehabilitación del Instituto de Cardiología y Cirugía Cardiovascular, La Habana, Cuba.
authors.forename: Susana
authors.initials: S
authors.lastname: Hernández García
mesh_terms: D002317:Cardiovascular Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D006333:Heart Failure / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D006801:Humans
chemical_list: D002317:Cardiovascular Agents