3/9/99 - Moderate exercise may be the best therapy for CHF patients. This long-term study shows sustained improvement in functional capacity and quality of life for CHF patients.
	The study, by researchers in Italy and the USA, was co-authored by Demetrios Georgiou, MD, Columbia Presbyterian Center of New York Presbyterian Hospital. The study is in the March issue of Circulation: Journal of the American Heart Association.
	It shows that CHF patients in a 14-month exercise program not only lived longer and had lower heart-related mortality but also had fewer hospital re-admissions than the control group after a 40 month follow-up.
	99 patients with stable CHF (88 men, 11 women) were randomized into an exercise (E) and a non-exercise (NE) group. Stable disease was defined as patients without rapid heart beats (malignant ventricular arrhythmias), no fluid in the lungs, and no heart attack within 3 months of entering the study. 50 patients exercised 3 times a week for 2 months on a stationary bicycle, and then twice weekly for 12 months. Each session was a 20 minute warm-up with stretching, followed by 40 minutes of cycling, supervised by a cardiologist.
	Almost 3 times as many patients in the NE group were re-hospitalized for CHF during the study compared with the E group (14 vs 5 patients). While 20 patients in the NE died of CHF, only 9 in the E group did. In addition, 6 patients in the NE group suffered sudden cardiac death compared to one in the E group. Patients in the E group reported a higher quality of life.
	Thallium stress tests, which measure blood circulation inside the heart, and oxygen uptake tests, which measure exercise capacity, improved in the E group. Catecholamine levels went down in the E group. Catecholamines are adrenaline-like substances that can cause heart failure to get worse.
	"These results clearly show that moderate exercise training improves functioning and that this benefit means a more favorable outcome for patients with stable CHF," notes Dr. Georgiou.
	"We believe that exercise not only improves blood flow in the heart, but that it also increases blood flow to the skeletal muscles. This increases CHFers' ability to function. Patients who feel better are more inclined to be physically active and increase their oxygen capacity, " explains Dr. Georgiou.
	While the study is encouraging, Dr. Georgiou cautions that even stable CHF patients should ask their doctors before starting an exercise program. Heart monitoring is important for the first 4-8 weeks.

Title: Moderate Exercise May Be Best Therapy for Congestive Heart Failure Study Shows That Activity Rather Than Bed Rest Reduces Risk of Cardiac Death
From: Columbia Presbytarian Center
Contact: Karin Eskenazi of Columbia Presbyterian Center 212-305-5587