| Autor: |
Alison M, Mudge, Charles P, Denaro, Adam C, Scott, Deborah, Meyers, Julie A, Adsett, Robert W, Mullins, Jessica M, Suna, John J, Atherton, Thomas H, Marwick, Paul, Scuffham, Peter, O'Rourke |
| Rok vydání: |
2017 |
| Předmět: |
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| Zdroj: |
JACC. Heart failure. 6(2) |
| ISSN: |
2213-1787 |
| Popis: |
This study sought to measure the impact on all-cause death or readmission of adding center-based exercise training (ET) to disease management programs for patients with a recent acute heart failure (HF) hospitalization.ET is recommended for patients with HF, but evidence is based mainly on ET as a single intervention in stable outpatients.A randomized, controlled trial with blinded outcome assessor, enrolling adult participants with HF discharged from 5 hospitals in Queensland, Australia. All participants received HF-disease management program plus supported home exercise program; intervention participants were offered 24 weeks of supervised center-based ET. Primary outcome was all-cause 12-month death or readmission. Pre-planned subgroups included age (70 years vs. older), sex, left ventricular ejection fraction (≤40% vs.40%), and exercise adherence.Between May 2008 and July 2013, 278 participants (140 intervention, 138 control) were enrolled: 98 (35.3%) age ≥70 years, 71 (25.5%) females, and 62 (23.3%) with a left ventricular ejection fraction of40%. There were no adverse events associated with ET. There was no difference in primary outcome between groups (84 of 140 [60.0%] intervention vs. 90 of 138 [65.2%] control; p = 0.37), but a trend toward greater benefit in participants age 70 years (OR: 0.56 [95% CI: 0.30 to 1.02] vs. OR: 1.56 [95% CI: 0.67 to 3.64]; p for interaction = 0.05). Participants who exercised to guidelines (72 of 101 control and 92 of 117 intervention at 3 months) had a significantly lower rate of death and readmission (91 of 164 [55.5%] vs. 41 of 54 [75.9%]; p = 0.008).Supervised center-based ET was a safe, feasible addition to disease management programs with supported home exercise in patients recently hospitalized with acute HF, but did not reduce combined end-point of death or readmission. (A supervised exercise programme following hospitalisation for heart failure: does it add to disease management?; ACTRN12608000263392). |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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