PMID- 25944851
OWN - NLM
STAT- MEDLINE
DCOM- 20160720
LR  - 20151010
IS  - 1753-9455 (Electronic)
IS  - 1753-9447 (Linking)
VI  - 9
IP  - 5
DP  - 2015 Oct
TI  - Regular exercise improves weight stability in patients with advanced heart 
      failure.
PG  - 297-304
LID - 10.1177/1753944715581146 [doi]
AB  - OBJECTIVES: The purpose of this study was to determine if a progressive, 
      prescribed home-based aerobic exercise program would alter the natural 
      physiological processes that maintain fluid balance stability in patients with 
      New York Heart Association (NYHA) class III/IV heart failure after medical 
      optimization (titration of oral medical therapy with or without the infusion of 
      an intravenous inotrope). METHODS: A total of 56 men and women from a large 
      tertiary trauma I hospital were enrolled with 56 subjects contributing to 
      baseline analysis and 42 subjects at 24 weeks. Subjects were diagnosed with heart 
      failure via NYHA classification IV or III for at least 6 months and were 
      hospitalized for a current acute decompensation exacerbation in which they were 
      being medically optimized. The exercise intervention was a home-based, 
      prescribed, progressive aerobic exercise program lasting for 24 weeks. The 
      exercise participants had weekly phone calls to gather data and progress the 
      exercise program and one 12-week follow up. The usual care participants received 
      random phone calls to collect data and had one 12-week follow up visit to attain 
      physical assessment values. RESULTS: Subjects were primarily female (59%), 
      nonwhite (54%), and NYHA class IV (52%) versus class III (48%). The mean age was 
      58 years (+/-11.8 years). The subjects had a mean ejection fraction of 17.7 % (+/-7%) 
      and mean maximal oxygen consumption of 12.1 (+/-3.4). Using a hierarchical multiple 
      regression model, it was demonstrated that an exercise prescription (intensity, 
      frequency, duration) significantly predicted 24 h weight fluctuations within a 
      NYHA class III/IV heart failure population after medical optimization (R(2) 
      linear = 0.713, F = 3.224, p = 0.015). CONCLUSION: This study demonstrated that 
      exercise is a successful adjunctive therapy to managing the daily weight 
      variability or fluid status instability of patients with NYHA class III/IV heart 
      failure that is often a debilitating aspect of the syndrome.
CI  - (c) The Author(s), 2015.
FAU - Boyd, Andrea M
AU  - Boyd AM
AD  - William J.B. Dorn VAMC, 6439 Garners Ferry Road, Columbia, SC 29209, USA 
      andrea.boyd@va.gov.
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20150504
PL  - England
TA  - Ther Adv Cardiovasc Dis
JT  - Therapeutic advances in cardiovascular disease
JID - 101316343
SB  - IM
MH  - Aged
MH  - Body Weight/*physiology
MH  - Exercise/*physiology
MH  - Exercise Therapy/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/physiopathology/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Oxygen Consumption/physiology
MH  - Regression Analysis
OTO - NOTNLM
OT  - body weight
OT  - exercise
OT  - fluid shifts
OT  - heart failure
EDAT- 2015/05/07 06:00
MHDA- 2016/07/21 06:00
CRDT- 2015/05/07 06:00
PHST- 2015/05/07 06:00 [entrez]
PHST- 2015/05/07 06:00 [pubmed]
PHST- 2016/07/21 06:00 [medline]
AID - 1753944715581146 [pii]
AID - 10.1177/1753944715581146 [doi]
PST - ppublish
SO  - Ther Adv Cardiovasc Dis. 2015 Oct;9(5):297-304. doi: 10.1177/1753944715581146. 
      Epub 2015 May 4.