Effect of Exercise Training on Health-Related Quality of Life in Patients With Chronic Heart Failure - HF-ACTION Substudy

Nov 19, 2008
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Author/Summarized by Author:
Anthony A. Bavry, MD, MPH, FACC
Summary Reviewer:
Deepak L. Bhatt, MD, MPH, MBA, FACC
Trial Sponsor:
National Heart, Lung, and Blood Institue
Date Presented:
01/01/2008
Date Updated:
11/19/2008
Original Posted Date:
11/19/2008
References

Description:

The goal of the trial was to evaluate exercise training compared with usual care among patients with heart failure.

Hypothesis:

Exercise training would improve the health status of heart failure patients.

Study Design

  • Randomized
  • Parallel
  • Stratified

Mean Follow Up: (Median) 2.5 years
Mean Patient Age: (Median) 59 years
Female: 30%
Mean Ejection Fraction: 25%

Patient Populations:

  • Patients with chronic heart failure (New York Heart Association class II-IV) on optimal medical therapy with left ventricular ejection fraction ≤35%
  • Patients must be capable of exercising

Primary Endpoints:

  • Change in Kansas City Cardiomyopathy Questionnaire score

Drug/Procedures Used:

Patients were randomized to an aerobic exercise training program (n = 1,159) vs. usual care (n = 1,172).

Health status was assessed by the Kansas City Cardiomyopathy Questionnaire.

Principal Findings:

Overall, 2,331 patients were randomized. The median age was 59 years, 30% of participants were women, the median left ventricular ejection fraction was 25%, and the median body mass index was 30 kg/m2.

At follow-up, the Kansas City Cardiomyopathy Questionnaire score had increased 5 points in the exercise group compared with 2 points in the usual care group (p = 0.001). This effect was seen early and persisted throughout follow-up. At 12 months, 53% of the exercise group demonstrated clinical improvement compared with 33% of the usual care group (p < 0.001).

Interpretation:

Among patients with chronic heart failure due to left ventricular systolic dysfunction, participation in an exercise program modestly improves health status compared with usual care. This benefit is seen early, within the first 3 months.

References:

Presented by Dr. Kathryn Flynn at the American Heart Association Annual Scientific Sessions, New Orleans, November 2008.

Keywords: Follow-Up Studies, Body Mass Index, Cardiomyopathies, Exercise, Exercise Therapy, Heart Failure, Stroke Volume, Surveys and Questionnaires, Health Status


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