[Evaluation of the effectiveness of exercise-based controlled physical effort in women with heart failure in the...

Heart failure (HF), especially during old age, significantly influences the decrease in physical fitness, depriving the patient of their independence during everyday life. The positive results of cardiac rehabilitation are one of the most well documented methods of lowering the frequency of hospitalisation and unfavourable prognosis of cardiovascular diseases. Currently complex cardiac rehabilitation is recommended by the American College of Cardiology (ACC) and American heart Association (AHA) as being an important element of treating patients with HF. However these recommendations are poorly executed in the everyday clinical practise, concerning elderly patients.

The aim of study is the assessment of the efficacy of controlled physical activity in elderly women, in their VII-X decades, with stable cardiac failure, based on exercise training.

The study included a group of 55 elderly women (mean age 84.73 ± 7.13 tears) with stable heart failure, NYHA II-III. In each patient plasma concentration of B-type natriuretic peptide was measured and a 6 minute walk test (6MWT) was undertaken.

In the study group of patients who underwent a 12 weeks of cardiac rehabilitation (72%) a decrease in level of NT-proBNP was observed after completion of physical training. The mean value decreased by 204.7pg/ml. Cardiac rehabilitation resulted in an improvement of physical fitness capacity in the group that qualified for fitness training, which was observed by an increase in distance covered during the 6MWT, initial distance of 236 (±127)m to a distance of 300.9 (±75.9)m. Furthermore using statistical analysis it was shown that in the group qualified for cardiac rehabilitation, there is a positive correlation between distance covered during the 6MWT and the improvement in clinical symptoms as measured by the NYHA classification, r=0.099, p>0.05.

Cardiac rehabilitation modified for the individual needs and abilities of the patient is one of the significant elements that make up the complex therapy of elderly women with HF. Systematically undertaken physical activity occupies an important place in the prevention of cardiovascular disorders, by increasing the level of physical fitness, as manifested by the increase in distance covered during the 6MWT and by the change in classification of NYHA to a higher class or by the decrease in plasma concentration of NT-proBNP.