Dissertation committee:
Σεραφείμ Νανάς, Ομότιμος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ευστάθιος Ηλιοδρομίτης, Ομότιμος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Χριστίνα Ρούτση, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Ιωάννης Βασιλειάδης, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ελένη Μάγειρα, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Παρασκευή Κατσαούνου, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Νικολέττα Ροβίνα, Επίκουρη Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Summary:
Background: Chronic heart failure (CHF) is a complex syndrome characterized by a progressive reduction of the left ventricular (LV) contractility, low exercise tolerance and raised mortality and morbidity. Diastolic dysfunction of the LV is a keystone in the pathophysiology of CHF and plays a major role in the progression of most cardiac diseases. Also, it is well established that exercise training induces several beneficial effects on patients with CHF.
Aim: The aim of the present study was to evaluate the impact of a cardiac rehabilitation program on the grades and other indices of diastolic dysfunction of the LV, the ejection fraction (EF) of the LV and the peak oxygen uptake and the workload in patients with CHF and EF < 50%. Also, the whole cohort was assigned randomly in aerobic exercise, or a combined aerobic and exercise group and all the indices were compared.
Methods: Thirty-two stable patients with CHF (age: 56 ± 10 years, EF: 32 ± 8%, 88% men) participated in an exercise rehabilitation program. They randomly assigned to aerobic exercise or combined aerobic and strength training. Before and after the program, they underwent a symptom-limited maximal cardiopulmonary exercise testing (CPET) and serial echocardiography evaluation.
Results: The whole cohort improved peak oxygen uptake and workload p < 0.05). The whole group also improved diastolic dysfunction, as assessed with grades. Overall, 9 patients (28.1%) improved grade, while 23 ones (71.9%) remained at the same grade. A significant difference was observed between these groups of patients, considering grade at baseline (p < 0.05). The whole sample did not improve any of the other diastolic dysfunction variables examined (p > 0.05). In addition, the whole cohort improved the Right Ventricular Systolic Pressure (RVSP) and the EF (p < 0.05). Not any between-group differences were observed in the variables assessed (p > 0.05).
Conclusions: Exercise rehabilitation improves indices of diastolic and systolic dysfunction. Exercise protocol was not observed to affect outcomes. These results need to be further investigated in larger samples.
