Cor Vasa 2025, 67(5):601-612 | DOI: 10.33678/cor.2025.061

Short-term effects of exercise training program on patients with compensated chronic heart failure

Omar El Tahan, Ghada Youssef, Yasser Baghdady, Mohamed Abdelghany, Ahmed Mohsen

Department of Cardiology, Faculty of Medicine, Kasr Al Ainy - Cairo University, Cairo, Egypt

Background: About 1% to 2% of adults suffer from heart failure (HF), a complex syndrome with significant clinical and public health issues. Exercise training for heart failure seeks to enhance patients' physical fitness and quality of life while simultaneously diminishing the likelihood of hospitalizations and mortality. Poor heart failure patient participation was apparent despite strong guidelines for cardiac rehabilitation.

Objectives: For evaluating how a brief, structured exercise training program impacts those suffering from compensated chronic heart failure in terms of improving clinical, laboratory, and echocardiographic parameters.

Methods: 107 medically stable outpatients with chronic heart failure (HFrEF and HFmrEF) participated in a randomized control trial. Participants were allocated to either the exercise or control groups between May 2022 and June 2023. Intervention: usual care plus aerobic exercise training for 12 weeks. 6MWT, KCCQ-12, blood samples for routine labs and serum NT-proBNP were collected and conventional echocardiography and 2D-speckle tracking studies were done at baseline and after 12 weeks, the adverse events after 12 weeks were recorded including cardiovascular death, ER visits and hospitalization.

Results: Exercise group (n = 60) and control group (n = 47) were allocated at random to the patients. Both groups were dominated by males, and 58% of the exercise group and 68% of the control group had ischemic etiology. With the overall adherence to the exercise training program being 83.7%, the 58 exercise group patients (96.7%) underwent continuous exercise training while the rest underwent high intensity interval training. Our research revealed that the exercise group significantly improved their functional capacity by increasing their 6MWT distance (420 vs 260 m, p ≤0.001) and VO_2max (16.8 vs 14.7 ml/kg/min, p ≤0.001), additionally their quality of life by 8 points on the KCCQ-12 when compared to the control group (p ≤0.001). The exercise group's global longitudinal strain (-12.5 vs. -9.7%, p = 0.005) and ejection fraction (37.8 vs. 33.1%, p = 0.04) both significantly improved when in comparison to the control group. At the follow-up, there was insignificant difference in the NT-proBNP between the two groups. The exercise group experienced fewer hospitalized patients than the control group, which was statistically significant (p = 0.045). Other adverse events were comparable in both groups. 6MWT, VO_2max (p ≤0.001), NT-proBNP levels (p = 0.05), decreased heart rate (p = 0.005), decreased LV end-diastolic (p = 0.007), end-systolic volumes (p ≤0.001), and improved ejection fraction (p ≤0.001) were all significantly improved when comparing baseline and follow-up data of the exercise group.

Conclusions: Regular exercisers with chronic heart failure report improving ejection fraction, quality of life, functional capacity, and fewer adverse events, encompassing hospitalization as well.

Received: January 22, 2025; Revised: March 20, 2025; Accepted: April 3, 2025; Prepublished online: June 2, 2012; Published: November 6, 2025  Show citation