Moderate Exercise Good Therapy for Congestive Heart Failure.

• Position: Brief Article

Moderate exercise--rather than traditional bed rest--may be the best therapy for patients with congestive heart failure (CHF), according to the results of the first long-term study to show a sustained improvement in functional capacity and quality of life for these patients. In CHF, the heart cannot pump enough blood throughout the body in order to meet the needs of the other organs. As a result, excess fluid accumulates in the lungs and tissues, making it hard for CHF patients to breathe easily and causing them to tire quickly. Their legs and ankles may also swell, resulting in difficulty in walking. Patients are usually treated with medications and reduced physical activity, although sometimes the heart becomes so damaged that a transplant is needed. CHF is the only cardiovascular disease increasing in the U.S.

The study by researchers in Italy and the U.S., co-authored by Demetrios Georgiou, assistant attending physician of the Department of Medicine at the Columbia Presbyterian Center of New York Presbyterian Hospital and assistant clinical professor of medicine at Columbia University College of Physicians & Surgeons, found that patients with CHF who were enrolled in a 14-month exercise program not only lived longer and had a lower cardiac mortality rate, but had fewer hospital readmissions than the control group after 40 months of follow-up.

Ninety-nine patients with stable CHF (88 men, 11 women) were randomized into an exercise and a nonexercise group. Stable disease was defined as patients without rapid heart beats, no fluid in the lungs, and no heart attack within three months of entering the study. Fifty patients exercised three times a week for two months on a stationary bicycle, then twice weekly for 12 months. Each exercise session consisted of a 20-minute warm-up phase of stretching exercise followed by 40 minutes of cycling, under the supervision of a cardiologist.

Fourteen patients in the control group were rehospitalized for CHF during the study, compared with five in the exercise group. While 20 patients in the control group died...