Heart 1997;78:431-436 ( November )

Review

The role of exercise training in chronic heart failure

Robert P Wielenga,^a Andrew J S Coats,^b Willem L Mosterd,^c Inge A Huisveld^c

^a Department of Cardiology, Ignatius Hospital, Breda, The Netherlands, ^b Royal Brompton Hospital, London SW3, UK, ^c Department of Medical Physiology and Sports Medicine, Utrecht University, Utrecht, The Netherlands

Correspondence to: Dr Wielenga, Department of Medical Physiology and Sports Medicine, Universiteitsweg 100, PO Box 80043, 3508 TA Utrecht, the Netherlands.

Accepted for publication 2 July 1997

The first 150 words of the full text of this article appear below.

	Introduction

Chronic heart failure is a major health problem with a gloomy prognosis. It is now the most common discharge diagnosis in patients over 65 years of age and its incidence may be expected to grow in coming years. Characteristic of the failing heart is its inability to maintain an adequate cardiac output, first during exercise and later also at rest. Patients with chronic heart failure have a large end diastolic volume and little contractile reserve.

Cardiac failure is thus a syndrome of circulatory failure, secondary to ventricular dysfunction. This primarily ventricular dysfunction is followed by a variety of neurohumoral, peripheral circulatory, skeletal muscle, and respiratory adaptations which determine the syndrome's clinical presentation and prognosis more than the primary ventricular dysfunction itself.

Traditionally, avoidance of exercise was thus advocated in all forms and stages of heart failure.¹ However, there is now evidence that inactivity leads to a further deterioration of remaining functional . . . [Full text of this article]

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