Both endurance training (ET) and cardiac resynchronization therapy (CRT) improve quality of life (QOL) and exercise tolerance in patients with advanced chronic heart failure (CHF).
Design
A randomized intervention trial to study the effect on exercise capacity of ET in addition to CRT in patients with CHF and dyssynchrony.
Methods
Seventeen patients (eight men, aged 59 ± 9 years) with CHF and dyssynchrony were randomized to CRT with (n = 8) or without (n = 9) ET and compared with two matched control CHF groups (standard care with ET: n = 9, standard care only: n = 10). At baseline and after 5 months, exercise tolerance, left ventricular (LV) remodelling, QOL and NT-pro brain natriuretic peptide (NT-proBNP) levels were assessed.
Results
Peak oxygen consumption (VO2peak), maximal workload (Wattmax), circulatory power, LV ejection fraction, dyssynchrony and QOL improved in both CRT groups. However, the increase in VO2peak (+ 40% versus +16%, P = 0.005), Wattmax (+ 43% versus +13%, P = 0.0005), and circulatory power (+ 74% versus + 32%, P = 0.01), was significantly greater in the trained versus the untrained CRT patients. Comparison of the four patient groups confirmed the cumulative effects of CRT plus ET.
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