Exercise May Lengthen Life In Patients With Congestive Heart Failure

November 10, 1998

DALLAS -- Based on a pilot study, exercise may be beneficial for patients with congestive heart failure.

Patients with this condition who worked out at a rehabilitation facility had higher survival rates after four years (92 percent) compared to patients who did not exercise (64 percent), according to Duke University Medical Center researchers.

These results further support the emerging evidence that congestive heart failure patients may benefit from exercise, said cardiologist Dr. David Whellan, who presented the findings at the 71st annual scientific sessions of the American Heart Association.

"Many physicians do not recommend exercise for patients with congestive heart failure because there hasn't been strong outcome evidence supporting a benefit, and the classic teaching has been not to stress patients with weakened hearts with exercise," he said.

But Whellan and the senior cardiologist on the research team, Dr. Christopher O'Connor, cautioned that the true benefit and any unknown risk of exercise in these patients will only be known if a large randomized trial is undertaken to answer the question. The physicians are now considering the feasibility of such a trial, which they believe is critically needed.

The trial of 1,420 patients treated at Duke was based on prospective information collected by the Duke Databank of Cardiovascular Disease, a collection of detailed treatment and outcomes information collected on every heart patient treated at Duke.

More than 400,000 cases of congestive heart failure are diagnosed in this country each year. And up to 4 million Americans suffer from it at any one point in time, at a cost of up to $40 billion annually, Whellan said.

Congestive heart failure describes different conditions in which the heart performs poorly and is progressively unable to effectively push blood to the rest of the body. Whellan dubs congestive heart failure "cancer of the heart" because the prognosis is so poor -- the five-year survival rate for the most severely affected patients is about 50 to 60 percent, he said.

While many of the symptoms of congestive heart failure are treatable using ACE inhibitors, beta blockers and, as a last resort, heart transplants, damage done to a patient's heart can't be reversed. Because of that fact, many physicians may not recommend exercise for their patients, believing it may damage heart tissue further, Whellan said.

Other Duke cardiologists had observed that patients with this syndrome who exercised did better whether or not they received a transplant, and so they routinely referred them for exercise rehabilitation. Therefore, the question Whellan's team looked at was whether exercise, in and of itself, could provide a survival benefit for patients with congestive heart failure.

They combed the Duke Databank looking for patients with this syndrome who had followed their physicians' advice to exercise at the Duke Center for Living, among other criteria. From 1991 through 1996, they found 70 patients who did, in fact, exercise, and 1,350 who didn't. Most of the patients in the two groups were similar in terms of age and gender, but 70 percent of patients in the group that followed advice to exercise had a history of heart attacks, compared to 47 percent in the non-exercise group.

After four years, 8 percent of patients who exercised were dead compared to 36 percent of those who didn't exercise. "That makes exercise as effective as the best drugs we can offer these patients," Whellan said.

Whellan noted that although no threshold number of training sessions could be found, he said that "if they ever went, they did better. That, of course, could indicate a bias in the study," he added. "Those people who exercised may just have been more inclined to take better care of themselves overall, compared to people who didn't exercise."

Duke University Medical Center

Related Congestive Heart Failure Articles from Brightsurf:

Top Science Tip Sheet on heart failure, heart muscle cells, heart attack and atrial fibrillation results
Newly discovered pathway may have potential for treating heart failure - New research model helps predict heart muscle cells' impact on heart function after injury - New mass spectrometry approach generates libraries of glycans in human heart tissue - Understanding heart damage after heart attack and treatment may provide clues for prevention - Understanding atrial fibrillation's effects on heart cells may help find treatments - New research may lead to therapy for heart failure caused by ICI cancer medication

Machining the heart: New predictor for helping to beat chronic heart failure
Researchers from Kanazawa University have used machine learning to predict which classes of chronic heart failure patients are most likely to experience heart failure death, and which are most likely to develop an arrhythmic death or sudden cardiac death.

Heart attacks, heart failure, stroke: COVID-19's dangerous cardiovascular complications
A new guide from emergency medicine doctors details the potentially deadly cardiovascular complications COVID-19 can cause.

Autoimmunity-associated heart dilation tied to heart-failure risk in type 1 diabetes
In people with type 1 diabetes without known cardiovascular disease, the presence of autoantibodies against heart muscle proteins was associated with cardiac magnetic resonance (CMR) imaging evidence of increased volume of the left ventricle (the heart's main pumping chamber), increased muscle mass, and reduced pumping function (ejection fraction), features that are associated with higher risk of failure in the general population

Beta blocker use identified as hospitalization risk factor in 'stiff heart' heart failure
A new study links the use of beta-blockers to heart failure hospitalizations among those with the common 'stiff heart' heart failure subtype.

Toilet seat that detects congestive heart failure getting ready to begin commercialization
A toilet-seat based cardiovascular monitoring system created by a team of Rochester Institute of Technology researchers aims to lower the hospital readmission rates of patients with congestive heart failure.

Novel heart pump shows superior outcomes in advanced heart failure
Severely ill patients with advanced heart failure who received a novel heart pump -- the HeartMate 3 left ventricular assist device (LVAD) -- suffered significantly fewer strokes, pump-related blood clots and bleeding episodes after two years, compared with similar patients who received an older, more established pump, according to research presented at the American College of Cardiology's 68th Annual Scientific Session.

NSAID impairs immune response in heart failure, worsens heart and kidney damage
Non-steroidal anti-inflammatory drugs, or NSAIDs, are widely known as pain-killers and can relieve pain and inflammation.

Oxygen therapy for patients suffering from a heart attack does not prevent heart failure
Oxygen therapy does not prevent the development of heart failure.

Epigenetic reprogramming of human hearts found in congestive heart failure
Congestive heart failure is a terminal disease that affects nearly 6 million Americans.

Read More: Congestive Heart Failure News and Congestive Heart Failure Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.