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Review: exercise training delays death and hospital admission in chronic heart failure

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 Q In patients with chronic heart failure (CHF) resulting from left ventricular systolic dysfunction, does exercise training reduce death or admission to hospital?

Clinical impact ratings GP/FP/Primary care ★★★★★★☆ IM/Ambulatory care ★★★★★★☆ Cardiology ★★★★★☆☆


Embedded ImageData sources:

Medline; Cochrane Reviews database; reference lists; abstracts presented at scientific meetings and published in Circulation, Journal of the American College of Cardiology, or European Heart Journal; and contact with researchers.

Embedded ImageStudy selection and assessment:

randomised controlled trials (RCTs) from 1990 on that evaluated exercise training (without any other simultaneous intervention) in patients who had CHF for ⩾3 months (resulting from left ventricular systolic dysfunction). The exercise programme had to last ⩾8 weeks and involve at least both legs. Individual patient data from all RCTs were entered into a master database for analysis.

Embedded ImageOutcomes:

death at ⩾3 months and hospital admission.


9 RCTs (8 from Europe) met the selection criteria. Sample size ranged from 27–181 …

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  • For correspondence: Dr M F Piepoli, Royal Brompton Hospital, London, UK.

  • Source of funding: Royal Brompton and Harefield NHS Trust Clinical Research Committee.