BENEFITS OF EXERCISE IN ELDERLY CONGESTIVE HEART FAILURE PATIENTS

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Exercise Testing & Training Facility utilization only. Chronic congestive heart failure (CHF) secondary to a reduction in left ventricular systolic function is extremely common in the elderly and contributes to a substantial decline in functional capacity. Many clinicians limit the physical activity of older patients with heart failure due to a fear of precipitating myocardial ischemia, worsening the symptoms of CHF, or eliciting serious dysrhythmias, thus promoting deconditioning and functional limitations. Younger CHF patients can derive substantial benefits from a regular aerobic exercise training. The effectiveness of aerobic and resistive training to increase the functional independence of old patients with CHF has not been addressed. It is our hypothesis that symptom-limited aerobic and resistive exercise training can be safely performed in the elderly. This prospective, randomized trial will characterize the functional limitations of older New York Heart Association (NYHA) class II and III heart failure patients and determine if a combined protocol of aerobic/resistive exercise is more effective than aerobic training alone in improving physical activity and maximal aerobic capacity. These aims will be assessed by a direct comparison of the aerobic and combined aerobic/resistive training protocols to age- matched controls receiving usual care in a randomized, prospective study design. The effects of exercise training on the mechanisms that may be responsible for the benefits will be carefully assessed including: 1) muscle strength, b) arterial compliance, 3) alteration in left ventricular function as assessed by 2D echocardiography and MUGA scan.