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Objective: To assess exercise capacity and left ventricular function using magnetic resonance imaging (MRI) among patients with chronic heart failure randomized to a residential rehabilitation programme at baseline and six years after participation. Design: Randomized controlled study. Setting: Residential cardiac rehabilitation centre and community hospital. Intervention: One month of intensive exercise and risk reduction therapy including educational sessions, a low-fat diet, and 2 hours of individually prescribed exercise daily. Control subjects received usual care. Subjects were evaluated at baseline, after completing the one-month residential programme and six years later. Subjects: From an original study group of 50, 16 patients (8 exercise, 8 controls) with chronic heart failure were alive and available for evaluation after six years. Main measures: Cardiopulmonary exercise test responses and ventricular size and function using MRI. Results: Peak Vo2 was 20.0 and 12.4% higher after the rehabilitation programme and six years later, respectively, whereas minimal changes were observed among controls. Left ventricular mass and volumes tended to decrease among subjects in the exercise group, whereas left ventricular mass and volumes tended to increase among control subjects after six years. Ejection fraction increased approximately 20% in both groups. Conclusion: Six years after participation in a concentrated residential rehabilitation programme, exercise capacity was preserved and no significant changes were observed in ventricular size or function. These findings provide further support for exercise rehabilitation in chronic heart failure. [ABSTRACT FROM AUTHOR]

Objective: To determine the short- and long-term effects of an intensive, concentrated rehabilitation programme in patients with chronic heart failure. Design: Randomized controlled trial, with one-month and six-year evaluations. Setting: Residential rehabilitation centre in Switzerland. Subjects: Fifty patients with chronic heart failure, randomized to exercise or control groups. Interventions: A rehabilitation programme lasting one month, including educational sessions, a low-fat diet, and 2 hours of individually prescribed exercise daily. Main measures: Exercise test responses, health outcomes and physical activity patterns. Results: Peak Vo2 increased 21.4% in the exercise group during the rehabilitation programme (P50.05), whereas peak Vo2 did not change among controls. After the six-year follow-up period, peak Vo2 was only slightly higher than that at baseline in the trained group (7%, NS), while peak Vo2 among controls was unchanged. During longterm follow-up, 9 and 12 patients died in the exercise and control groups, respectively (P = 0.63). At six years, physical activity patterns tended to be higher in the exercise group; the mean energy expenditure values over the last year were 2704±1970 and 2085±1522 kcal/week during recreational activities for the exercise and control groups, respectively. However, both groups were more active compared to energy expenditure prior to their cardiac event (P < 0.001). Conclusions: Six years after participation in a residential rehabilitation programme, patients with chronic heart failure had slightly better outcomes than control subjects, maintained exercise capacity and engaged in activities that exceed the minimal amount recommended by guidelines for cardiovascular health. [ABSTRACT FROM AUTHOR]