Chronic heart failure

There are increasing numbers of patients presenting with heart failure and being referred to CR. Because of the negative effects on quality of life for these patients due to dyspnoea on exertion and fatigue and the generally poor prognosis, the interest in optimising the management of this patient group is increasing. The review of controlled trials of physical training in chronic heart failure by the European Heart Failure Group (1998) concluded that there are positive effects of physical rehabilitation in stable heart failure patients on function and quality of life. A further systematic review of evidence by LloydWilliams, et al. (2002) found that short-term physical exercise training in selected subgroups of patients with chronic heart failure has physiological benefits and positive effects on quality of life. These findings are confirmed, with a collaborative meta-analysis, by ExTraMATCH (2004), providing evidence of an overall reduction in mortality for HF groups. The largest improvements in exercise capacity and quality of life are found in those patients with mild to moderate HF (Rees, et al., 2004).

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