MedWire News: Patients with stable heart failure benefit more from aerobic exercise than any other type of physical activity programme, researchers have found.

“If I were to choose a type of exercise training for a patient with heart failure, I’d choose aerobic exercise,” said lead researcher Dr Mark Haykowsky, from the University of Alberta in Edmonton, Canada. “It’s aerobic training that provides the greatest benefit.”

People with heart failure have enlarged, misshapen hearts that are too weak to pump blood effectively around the body. Sufferers therefore become very short of breath and find it difficult to perform everyday activities.

In the past, doctors recommended that people with heart failure avoid physical activity as it was thought to put excessive strain on their hearts.

But recent studies have shown that exercise can benefit heart failure patients by reducing their symptoms and allowing them to live more active lives. However, it was not known what type of exercise was best for heart failure patients.

To investigate, Dr Mark Haykowsky and his team reviewed the results of 14 studies involving 812 patients with stable heart failure.

The participants were assigned to one of three exercise programmes: aerobic exercise alone, aerobic exercise combined with strength training, or strength training alone. Patients assigned to aerobic exercise typically walked or cycled for 20 to 60 minutes three times a week at 60-80% of their peak ability.

Analysis of the results showed that patients assigned to aerobic exercise alone experienced nearly a 3% improvement in their heart’s ability to pump blood, as well as a slight reduction in the size of their hearts.

Participants who combined aerobic exercise with strength training experienced no such improvements, while those assigned to strength training alone actually experienced a reduction in their heart’s ability to pump blood.

Commenting on the findings in an accompanying article, Professor Stanley Rubin, from the University of California Los Angeles, said: ““This study clarifies for heart failure patients and for their doctors the best form of exercise training. But it’s not a bed of roses.

“The patient needs to be motivated, have realistic expectations of the small but real benefit of exercise and, in particular, understand that this form of treatment must be accompanied by extensive dietary, lifestyle and, especially, medication and device treatments tailored to meet their needs. It’s not a substitute.”

The research appears in an advance online publication by the Journal of the American College of Cardiology.