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  • Review Article
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Clinical utility of exercise training in chronic systolic heart failure

Nature Reviews Cardiology volume 8, pages 380–392 (2011)Cite this article

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Abstract

The volume of literature attesting to the clinical benefits of exercise training in patients with stable chronic heart failure (CHF) is substantial. Training can improve symptoms and exercise capacity, as well as reducing morbidity, mortality, and rates of emergency hospitalization. These benefits are apparent in all patients with stable CHF, irrespective of age or sex, or the etiology or severity of heart failure. Training regimens for patients with stable, systolic CHF should form part of a comprehensive heart-failure support effort and are best delivered using supervised in-hospital exercise combined with some training at home or in a group setting in community centers. In this Review, the modes and intensity of exercise training, selection of patients, duration of training effects, and other clinical guidance for using this treatment option are discussed.

Key Points

  • Exercise training in patients with heart failure has been the subject of more than 100 studies since 1990

  • Several systematic meta-analyses and systematic review have confirmed that training can improve exercise capacity by 15–20% in patients with heart failure

  • Multiple randomized controlled trials have shown that exercise training improves quality of life in patients with heart failure and strongly suggest benefits in terms of major clinical outcomes

  • Long-term aerobic exercise training at ≥40% of maximal capacity either at home or in hospital, combined with resistance training, is recommended for all patients with stable systolic heart failure

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Figure 1: Kaplan–Meier curves for patients with stable chronic heart failure undergoing exercise training versus controls.
Figure 2: Schemes of the steep ramp test and of interval exercise training used by Meyer and colleagues.
Figure 3: Subgroups for the effect of training on hospitalization-free survival in patients with chronic heart failure.

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    Andrew J. Stewart Coats

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Coats, A. Clinical utility of exercise training in chronic systolic heart failure. Nat Rev Cardiol 8, 380–392 (2011). https://doi.org/10.1038/nrcardio.2011.47

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