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    Exercise Boosts Blood Flow in Heart-failure Patients

    Exercise is not just for healthy people: If patients with stable chronic heart failure exercised every day for 20 minutes, they too would feel alot better, and it would help their heart, new research suggests. Moderate regular exercise improved circulation, left ventricular function, and heart function.

    Traditionally, doctors have not recommended strenuous exercise in people with chronic heart failure. But over the past ten years, researchers have shown that inactivity can worsen heart conditions.

    In a study published in the June 21 Journal of the American Medical Association, 36 male, middle-aged heart failure patients began an exercise program under the close supervision of their doctors. For two weeks the patients exercised in the hospital on stationary bicycles for ten minutes, four to six times per day. Then for six months they bicycled at home for 20 minutes per day at 70 percent of peak oxygen uptake. Once a week, they participated in a one-hour exercise class that included walking, calisthenics, and ball games.

    After six months, the men had improved exercise capacity, decreased resting heart rate, increased stroke volume, and increased "maximal ventilation" or oxygen uptake, compared to a group of 37 non-exercisers, who were in similar health to start. Other important measurements of blood flow or circulation, which effects general well-being, also improved. Dr. Rainer Hambrecht of Universitat Leipzig in Leipzig, Germany, and colleagues published the study.

    As a result of the exercise, the men experienced a decrease in their peripheral resistance, which is pressure on the arteries that slows blood flow, while they were at rest and during exercise. Peripheral resistance worsened in the non-exercisers over the six months, meaning their hearts had to work harder to pump blood.

    The exercise group also made "small but significant improvements" in increasing the amount of blood their hearts pumped with each beat and in decreasing the size of their hearts, which had become dangerously enlarged, the team reports. Their resting heart rate also decreased, reflecting an improved heart function.

    Other studies have shown that exercise improves the work capacity of patients with chronic heart failure by enhancing endothelial function and skeletal muscle aerobic metabolism, the team notes. This means that exercise restores the ability of blood vessels to regulate the amount of blood that the tissues need. But the effects on heart rate, heart pump function and peripheral vascular resistance had remained unclear.


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