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Edelmann, F; Pieske, B.
Exercise training in heart failure].
Herz. 2013; 38(6):578-586 Doi: 10.1007/s00059-013-3918-8
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Co-Autor*innen der Med Uni Graz
Pieske Burkert Mathias

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In patients with chronic but stable heart failure (HF) exercise training is a recommended and widely accepted adjunct to an evidence-based management involving pharmacological and non-pharmacological therapies. Various pathophysiological mechanisms, such as central hemodynamics, vasculature, ventilation, skeletal muscle function as well as neurohormonal activation and inflammation are responsible for exercise intolerance described in HF patients. There is sufficient and growing evidence that exercise training in HF with reduced (HFrEF) and with preserved ejection fraction (HFpEF) is effective in improving exercise capacity, HF symptoms and quality of life. The positive effects of exercise training in HF are mediated by an improvement of central hemodynamics, endothelial function, inflammatory markers, neurohumoral activation, as well as skeletal muscle structure and function. In contrast to convincing data from a large meta-analysis, the large HF-ACTION study (Heart Failure-A Controlled Trial Investigating Outcomes of exercise TraiNing) only demonstrated a modest improvement of all cause mortality and hospitalizations in HFrEF. Outcome data in HFpEF are lacking. Whether interval training incorporating variable and higher intensities or the addition of resistance exercise to a standard aerobic prescription is superior in improving clinical status of HF patients is currently being examined. Despite increasing validation of the potential of exercise training in chronic HF, challenges remain in the routine therapeutic application, including interdisciplinary management, financing of long-term exercise programs and the need to improve short-term and long-term adherence to exercise training.
Find related publications in this database (using NLM MeSH Indexing)
Evidence-Based Medicine -
Exercise Therapy - methods
Heart Failure - mortality
Humans -
Prevalence -
Risk Factors -
Survival Rate -
Treatment Outcome -

Find related publications in this database (Keywords)
Left ventricular function
Exercise intolerance
Endurance training
Strength training
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