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Exercise Effective Even in Heart Failure Patients

By Kristina Fiore, Staff Writer, MedPage Today
Published: May 08, 2009
Reviewed by Zalman S. Agus, MD; Emeritus Professor
University of Pennsylvania School of Medicine. Earn CME/CE credit
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LITTLE FALLS, N.J., May 8 --
Researchers have found more evidence that exercise is beneficial in cardiovascular disease, even in heart failure.

Three studies presented at the congress of the European Association of Cardiovascular Prevention and Rehabilitation meeting in Stockholm have found that exercise improves outcomes after CABG surgery, in stable coronary artery disease, and in heart failure.

Clyde W. Yancy, M.D., of Baylor University, co-author of recent updates to treatment guidelines for chronic heart failure, said the abstracts are consistent with the growing body of evidence about the benefits of exercise.

In patients with stable heart failure, exercise improved endothelial function, Marcus Sandri, M.D., of the University of Leipzig in Germany, and colleagues reported at the conference.

The effects of exercise did not diminish with age, Dr. Sandri said.

The researchers randomized 50 patients with stable heart failure to an exercise regimen of four short sessions daily for four weeks, or to a control group that didn't exercise. An additional 50 healthy subjects were also randomized to an exercise or control group.

In both young and old heart failure patients who exercised, flow-mediated dilation improved significantly (from 9.2 to 13.1 in young patients and from 9.0 to 12.4 in old patients, P<0.05). No improvements were seen in the control group, the researchers said.

[...]

"There was a time when it was very reasonable to suggest the patient with heart failure needed to adopt a sedentary lifestyle because it was a concern that exercise might have worsened HF," Dr. Yancy said. "This represents research that was done or observations that were made many, many years ago, and over the last two decades there's been a growing clinical concern, and now a database to support that concern that, in fact, that original advice was not correct."

He said heart failure patients, unless they have abject heart failure, should be "encouraged to maintain a reasonable amount of activity."

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http://www.medpagetoday.com/Cardiology/CoronaryArteryDisease/14129