[Rehabilitation in chronic heart failure]

The functional capacity of patients with chronic heart failure usually undergoes significant deterioration. Its decrease can be influenced by a low cardiac output, but is directly related to alterations at the level of the skeletal muscle. Cardiac rehabilitation programmes, which are therapeutic systems of multifactorial action (physical and psychological training, and guidelines for control of risk factors), have shown great benefits in this type of patients. There is an increase in the aerobic capacity, anaerobic threshold, O2 peak, cardiac out put and in the maximum O2 arteriovenous difference. This entails an improvement in functional capacity, which has a very positive influence on the psychological sphere. In view of the small number of cases included in the studies published, it is impossible to get to know the results at a prognosis level. The performance of physical training, which has to be carefully programmed, does not occasion more complications than when performed by low risk groups. There is no evidence proving that physical training deteriorates the ventricular function. The decrease in the ejection fraction found in some patients with very low values at the beginning of the programme could be secondary to other usual factors responsible for the negative evolution of this type of pathology.