Copyright
©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Effects of exercise training on diastolic and systolic dysfunction in patients with chronic heart failure
Ioannis Chaveles, Ourania Papazachou, Manal al Shamari, Dimitrios Delis, Argirios Ntalianis, Niki Panagopoulou, Serafim Nanas, Eleftherios Karatzanos
Ioannis Chaveles, 1st Department of Cardiology - Clinical Ergospirometry, Exercise and Rehabilitation Laboratory, “Evaggelismos” Hospital, Athens 10676, Greece
Ourania Papazachou, Niki Panagopoulou, Department of Cardiology, ”Helena Venizelou” Hospital, Athens 10676, Greece
Ourania Papazachou, Manal al Shamari, Dimitrios Delis, Niki Panagopoulou, Serafim Nanas, Eleftherios Karatzanos, Clinical Ergospirometry, Exercise and Rehabilitation Laboratory, ”Evaggelismos” Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens 10676, Greece
Argirios Ntalianis, Heart Failure Unit, Department of Clinical Therapeutics, ”Alexandra” Hospital, National and Kapodistrian University of Athens, Athens 11528, Greece
Author contributions: Chaveles I, Ntalianis A, Panagopoulou N, Shamari MA, and Delis D engaged in acquisition of data (echocardiographic measurements, cardiopulmonary exercise testing, and application of exercise rehabilitation program); Chaveles I and Karatzanos E contributed to the data analysis and results interpretation; Chaveles I and Papazachou O drafted the manuscript; Papazachou O, Nanas S and Katatzanos E critically revised the manuscript; All authors gave final approval.
Institutional review board statement: The study was approved by the Administration Board and the Ethics Committee of the 'Evangelismos' Hospital (Athens, Greece) (approval number: 43/28.03.2016).
Clinical trial registration statement: The clinical trial has been registered with ClinicalTrials.gov (NCT04916184).
Informed consent statement: All study participants provided written consent prior to study enrollment.
Conflict-of-interest statement: The authors of this manuscript have no conflicts of interest to disclose.
Data sharing statement: There is no additional data available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Eleftherios Karatzanos, PhD, Consultant Physician-Scientist, Instructor, Clinical Ergospirometry, Exercise and Rehabilitation Laboratory, ”Evaggelismos” Hospital, National and Kapodistrian University of Athens, 45-47 Ypsilantou Str, Athens 10676, Greece.
lkaratzanos@gmail.com
Received: April 3, 2021
Peer-review started: April 3, 2021
First decision: May 13, 2021
Revised: May 26, 2021
Accepted: July 23, 2021
Article in press: July 23, 2021
Published online: September 26, 2021
Processing time: 167 Days and 8.2 Hours
ARTICLE HIGHLIGHTS
Research background
Diastolic dysfunction (DD) of the left ventricular (LV) is a keystone in the pathophysiology of chronic heart failure (CHF). Exercise training in general induces several beneficial effects in CHF patients, including functional capacity, quality of life and clinical outcomes. In this study, the impact of a rehabilitation program on the DD and the ejection fraction (EF) of the LV is evaluated in patients with CHF and EF < 50%.
Research motivation
Exercise training induces several beneficial effects on CHF patients. However, the effects of exercise training on diastolic DD have not been adequately studied. This is also the case for the effects of different exercise regimes on DD.
Research objectives
The main aim of the study was to evaluate the impact of a cardiac exercise rehabilitation program, on the DD and the ejection fraction (EF) of the LV in patients with CHF. A secondary aim was the comparison of an aerobic and combined regimes to explore any potential difference on these indices.
Research methods
In this randomized clinical trial study, 32 patients with CHF were screened for inclusion/exclusion criteria and consented to attend a rehabilitation program and undergo related evaluations. They randomly assigned to aerobic exercise (AER) or combined aerobic and strength training, by a researcher not involved in the rest of the tasks. Before and after the program, they underwent a symptom-limited maximal cardiopulmonary exercise testing (CPET) and serial echocardiography assessment. The researchers performed these evaluations were blinded to participants’ allocation.
Research results
Exercise training overall beneficially affected DD grade, right ventricular systolic pressure (RVSP), EF of the LV and AER capacity. No differences between the aerobic and combined group were observed.
Research conclusions
In this study, the effects of an exercise training rehabilitation program (AER with/without strength training) were evaluated on the indices of diastolic and systolic cardiac function, in stable CHF patients. Exercise training overall induced benefits on the DD as assessed with grades, the EF of the LV, the RVSP and the AER capacity. The exercise protocol was not observed to affect outcomes.
Research perspectives
Future research is warranted to further explore the effects of different exercise training regimes on diastolic dysfunction.
