One hundred patients with NYHA class II-IV congestive heart failure who have no previous history of exercise training will be stratified into different groups depending upon gender and etiology of disease, and then randomized to 4 months of exercise training (ET, n=50) or no exercise training (NT, n=50). Ten sedentary adults (SA) without known coronary disease will be screened by surface echocardiography and perform exercise training as a comparison group. All subjects will perform pre, mid, and post cardiopulmonary exercise tolerance testing (ETT). ET and NT groups will complete pre and post Minnesota Living with Heart Failure Questionnaires (HFQ). The ET and SA groups will participate in 4 months of home-based exercise training 3-6 days per week. ET and SA subjects will be provided with a walking progression chart and exercise guidelines; weekly logs will be returned and subjects contacted via telephone on a weekly basis. Intensity will be prescribed at a perceived exertion level of """"""""moderate to somewhat hard:, and will be evaluated quartely by holter monitoring (weeks 3, 7, 11, and 15). Duration of exercise will be individualized. Brain naturetic peptide (BNP), troponin I (TI), and hemoglobin (Hgb), will be measured before and after the study on all participants to evaluate left ventricular wall stress, myocardial necrosis, and oxygen carrying capacity, respectively. The NT group will not be given an exercise prescription no follow up.
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