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Relation between volume of exercise and clinical outcomes in patients with heart failure.

Abstract：

OBJECTIVES:This study determined whether greater volumes of exercise were associated with greater reductions in clinical events. BACKGROUND:The HF-ACTION (Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training) trial showed that among patients with heart failure (HF), regular exercise confers a modest reduction in the adjusted risk for all-cause mortality or hospitalization. METHODS:Patients randomized to the exercise training arm of HF-ACTION who were event-free at 3 months after randomization were included (n = 959). Median follow-up was 28.2 months. Clinical endpoints were all-cause mortality or hospitalization and cardiovascular mortality or HF hospitalization. RESULTS:A reverse J-shaped association was observed between exercise volume and adjusted clinical risk. On the basis of Cox regression, exercise volume was not a significant linear predictor but was a logarithmic predictor (p = 0.03) for all-cause mortality or hospitalization. For cardiovascular mortality or HF hospitalization, exercise volume was a significant (p = 0.001) linear and logarithmic predictor. Moderate exercise volumes of 3 to <5 metabolic equivalent (MET)-h and 5 to <7 MET-h per week were associated with reductions in subsequent risk that exceeded 30%. Exercise volume was positively associated with the change in peak oxygen uptake at 3 months (r = 0.10; p = 0.005). CONCLUSIONS:In patients with chronic systolic HF, volume of exercise is associated with the risk for clinical events, with only moderate levels (3 to 7 MET-h per week) of exercise needed to observe a clinical benefit. Although further study is warranted to confirm the relationship between volume of exercise completed and clinical events, our findings support the use of regular exercise in the management of these patients.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Keteyian SJ,Leifer ES,Houston-Miller N,Kraus WE,Brawner CA,O'Connor CM,Whellan DJ,Cooper LS,Fleg JL,Kitzman DW,Cohen-Solal A,Blumenthal JA,Rendall DS,Piña IL,HF-ACTION Investigators.

doi

10.1016/j.jacc.2012.08.958

subject

Has Abstract

pub_date

2012-11-06 00:00:00

pages

1899-905

issue

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(12)04108-3

journal_volume

pub_type

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Relation between volume of exercise and clinical outcomes in patients with heart failure.