Physical Training Safe and Effective For Subset of CHF Patients

	July 6, 1999 - A Dutch team of clinicians says that
physical training is safe and beneficial for class II and III
chronic heart failure patients.
	Dr. R. P. Wielenga of Ignatius Hospital in Breda and
multicenter investigators involved in the Results of the Chronic
Heart Failure and Graded Exercise (CHANGE) study randomized 80
CHF patients to an "endurance training group" for 12 weeks or to
a control group. All patients had chronic heart failure class II
and III and were managed on drugs throughout the trial.
	Dr. Wielenga's group reports improvements in exercise
time and the anaerobic threshold in the endurance training group.
Physical training also "decreased the ventilatory equivalent for
carbon dioxide at submaximal exercise level" and improved quality
of life in training subjects compared with controls.
	The Dutch investigators report in the June issue of the
European Heart Journal that training was not effective for the
subpopulation of patients with a baseline exercise test that
lasted less than 7 minutes.
	Dr. Wielenga calls for individualized training programs
for these patients. "Even for patients in whom no significant
improvement can be achieved at any level," they comment, "the
change in attitude concerning rest in chronic heart failure may
be beneficial; the mere thought of being allowed to perform
physical activity instead of the prescribed rest may have a
positive impact on quality of life."

Eur Heart J 1999;20:872-879