Abstract
INTRODUCTION: Although exercise therapy has the potential to improve health outcomes of patients with Chronic Heart Failure (CHF), less than 50% of patients adhere to prescribed physical activity guidelines one year after Cardiac Rehabilitation (CR). We aimed to assess the effects of an extended CR program with 12-months of Graded Exercise Therapy (GET) and resistance exercise training (RT) on exercise capacity and long-term survival in patients with CHF. METHODS: This prospective cohort study included sixty CHF patients between 2009 and 2010. The GET-RT-program consisted of exercise sessions at 6 days/week. Total training time of aerobic exercises increased incrementally every other week without changing exercise intensity. RT consisted of 8 exercises with a durable resistance band. Guidance consisted of a step-down approach from in-hospital to home-based training. Cardio-pulmonary exercise tests were performed at baseline, 3, 6 and 12 months. Subsequently patients were propensity score matched on a 1:2 ratio with controls (n=117) from a CHF-registry of patients from the same clinic receiving usual out-patient care and the incidence of all-cause mortality was compared between both groups. RESULTS: Baseline VO2 peak was 15.0 ml/min/kg and significantly elevated at 3 months (+1.1 ml/min/kg (95%CI: 0.4-1.8), 6 months (+2.9 ml/min/kg (95%CI: 1.1-2.9) and 12 months (+2.6 ml/min/kg (95%CI: 1.4-3.8). During 8 years of follow-up n=23 (38.3%) patients of the GET-RT-program died versus n=63 (53.8%) patients of the control group (p= 0.063). CONCLUSION: The 12 month GET-RT-program was associated with an improved fitness during one-year follow-up, whereas a tendency towards better survival rates was observed during long-term follow-up.
