Abstract P385: Physical Rehabilitation in Patients With Severe Heart Failure
Background: Physical exercises are very important as part of comprehensive cardiac rehabilitation(CR) for patients with heart failure (HF) due to increasing physical capacity and decreasing the number of pneumonias and hospitalizations but many protocols of physical exercises are not applicable for the patients with severe HF and lean body mass deficit (LBMD).
Purpose: To study the possibility and efficacy of respiratory muscles trainings (RMT) in patients with NYHA class III-IV heart failure and LBMD.
Methods: 56 patients 65,4±8,2 years old with NYHA III-IV HF with LBMD were randomized to either an exercise training group (EG)(28 pts) or to a control group (CG). The CG patients had standard drug therapy according to the European guidelines and nutrition with oligomeric nutrient mixtures. The EG participated additionally in a RMT with gradual increase of inspire and expire resistance. Trainings were held for 16 minutes twice a day for 12 months. Physical capacity by 6 minute walking test (6 MWT), lean body mass (LBM) by bio-impedance method, maximal inspiratory mouth pressures (PImax) and heath related quality of life by SF-36 were measured at baseline and in 12 months. Results: After 12 months patients EG showed better increase in results of 6 MWT (28,5%±3,1in EG vs 23,8 ± 2,6 in CG p<0,05) and PImax in EG (median PI max, 6,9 in both groups [25th-75th percentile range 6,3-7.2 in EG vs 25th-75th percentile range 6,2-7,1 in CG] at baseline, p=0,7), after 12 months EG median PI max, 7,3 in EG [25th-75th percentile range6,8-7,5] vs median PI max, 6,4 [25th-75th percentile range 6,1-6,3] in CG, p<0,01). There was no significant deference in LBM increase in both groups (4,2% in EG vs 3,6% in CG, p>0,5). Health-related quality of life increased in both groups, but in EG patients’ results in physical functioning, vitality, role emotional scales were significantly higher. EG patients had significantly less hospitalizations because of HF progression (16,8% in EG vs 19,1% in CG) and pneumonias (12,7% vs 15,7%). There were less lethal outcomes in EG (16,9% vs 18,8%in CG).
Conclusion: RMT in patients with severe HF and LBMD are effective in increasing physical capacity, maximal inspiratory mouth pressures, health-related quality of life and decreasing the number of hospitalizations because of HF progression and pneumonias more then oligomeric nutritional mixtures alone.
Author Disclosures: E. Kolesnikova: None. G. Arutyunov: None. A. Rylova: None. V. Lobzeva: None.
- © 2015 by American Heart Association, Inc.