The Effect Of Aerobic Exercise On Patients With Chronic Heart Failure

Heart Failure is a progressive heart disease when the muscle of the heart is weakened so that it cannot pump blood as it should; the blood backs up into the blood vessels around the lungs and the other parts of the body (NHS Choice, 2015). In heart failure, the heart is not able to maintain a normal range cardiac output to meet the metabolic needs of the body (Kemp and Conte, 2012). Heart failure is a major worldwide public health problem, it is the end stage of heart disease and it could lead to high mortality. At present, heart failure is usually associated with old age, given the dramatic increase in the population of older people (ACCF/AHA, 2013). In the USA, there are about 5.7 million adults who have heart failure, about half of the people die within 5 years of diagnosis, and it costs the nation an estimated $30.7 billion each year (ACCF/AHA, 2013).

Mountings of evidence exist on the benefits of physical activity and exercise for patients who have experienced a heart failure (HF) in recent years. HF occurs irrespective of age, therefore there will be no age categorisation within this report even though it is decidedly prevalent in older people, however, distinction will be made in relation to the group most likely to experience an event where pertinent. Owing to that, the intent of this report will be to asses the impact of physical activity and exercise on mortality and morbidity outcomes of those who have experience an event, as well as the advancement of quality taking into account the prognosis of the patients and their ability to undergo a particular exercise prescription.

Heart failure is when the heart cannot keep up with the immense demands placed on it by the body, and it starts to compensate causing remodeling of the cardiac cells due to stronger cardiac contractions. The heart chambers expand so they can fill with more blood to pump to the rest of the body, and the heart rate will increase to meet these demands (American Heart Association, 2015). Heart failure is the inability of the heart to fill and pump effectively enough to meet the metabolic demands of the body resulting in pulmonary and venous congestion (Lam et al., 2007). Over time the body can no longer compensate, and the person becomes symptomatic and progresses into worsening heart failure. The pulmonary and venous congestion or “fluid overload” will manifest itself in the form of lower extremity edema, shortness of breath, fatigue and even chest pain, which interferes with quality of life (Colucci, 2015).

Heart failure is more commonly diagnosed in the elderly population. There are ways to help manage heart failure like lifestyle modifications and use of pharmacology, and assessment for surgical intervention. Treatment of heart failure requires intensive medical, dietary, behavioral, and lifestyle modification to achieve improved quality of life, fewer hospitalizations, and decreased mortality (Singh, H., McGregor, Nigro, Higginson, and Larsen, 2014).

Heart failure is a chronic, debilitating disease affecting 5.1 million Americans. It is the most common cause of hospital admissions for Medicare beneficiaries, and is the diagnosis associated with most readmissions (Sterne, Grossman, Migliardi, & Swallow, 2014). Lower quality of life is experienced by patients with heart failure. Mortality rates remain high with about 30% of patients dying within the first year after diagnosis (Vellone et al., 2013). In the U.S. heart failure has become a major public health concern. The number of annual hospitalizations for individuals with heart failure increased from 2.4 million to 3.6 million from 1990 to 1999 (Veroff et al., 2012). Therefore, it is imperative to develop interventions to better

Patients with congestive heart failure must be careful of the amount of physical activity they participate in. Short spurts of low-level exercise are often safe to perform, but it is important not to make the heart work too hard for its reduced capacity. Heart failure in its

(Heart Failure Society of America, 2010). HF is accountable for 25% of all readmission within 30 days in the United States and represents an estimated $17 million dollars in healthcare spending (Desai, 2012). HF is most commonly seen in person’s age 65 or greater with common clinical presentations of dyspnea with exertion, orthopnea, edema in lower extremities and weight gain Patients often experience frequent exacerbations and decompensations (Anderson, 2014). The Heart Failure Society of America (2010) published the Comprehensive Heart Failure Practice Guidelines with the underlying goal to improve symptoms and to optimize the patient’s volume status. These guidelines include evidence based recommendations for “prevention, evaluation, disease management, and pharmacologic and device therapy” (Heart Failure Society of America, 2010, p 476). The Institute for Healthcare Improvement (n.d.) supports the balance of evidence based treatment during acute admission but asserts that it is equally as important to assess and provide patient education for self-management after

Patients with chronic heart failure present with decreased exercise tolerance. It is important that a well-designed exercise prescription is followed at all times and the appropriate health care provider such as the cardiologist is in agreement with your treatment plan. Query the physician if there is any specific exercise precautions or guidelines that are distinct to the patient. Furthermore, these particular patient populations may sometimes overexert themselves. Symptoms such as dyspnea, dizziness or lightheadedness,

CHF is a common disease with 900,000 people living with it (NICE, 2011) and 68,000 new cases a year in the UK (Sutherland, 2010). CHF is a clinical condition that can result from any cardiac disorder that impairs the ability of the heart to deliver adequate cardiac output during exercise or rest (Wier et al, 2006). The most common causes of heart failure are coronary heart diseases, high blood pressure and diabetes. According to the New York Heart association scale (AHA, 2014) they can be classified in 4 types depending on the severity of the condition’s limitations and symptoms in relation to physical activity.

Intro- Heart Failure is a multifactorial disease due to significant diminishing of heart pumping action. This is occurs in response to many underlying disease such as diabetes, hypertension, myocardial infarction and cardiac myopathies. These conditons lead to hemodynamic instability, neuroendocrine imbalances and structural remodeling of cardiac myocytes. Early less sever hf allows for compensatory mechanisms such as neuroendocrine stimulation- (beta adrenbergic r endothelin norepinephrine r), and hypertrophy which allow for sufficient left ventricular pumping action. However as hf develops these mechanisms become unable to compensate for the progressive underlying disease which results in further loss of contraction and relaxation efficiency and loss of regulation.

Exercise training would reverse exercise intolerance by reversing the changes leading to increased oxygen delivery and uptake. It has been shown that exercise training could be a good treatment for heart failure with preserved ejection fraction leading to an increased quality of life (3). High-intensity aerobic exercises in small intervals are recommended for heart failure with preserved ejection fraction (3). However, continuous moderate intensity aerobic exercises are effective as well (3). Discuss the different exercise programs with your healthcare professional to find the best exercise program for you.

Heart failure is a common cardiovascular condition affecting over 5 million individuals in USA. About 400,000 to 700,000 new cases of heart failure are diagnosed each year and carry a mortality of up to 250,000 per year (1). The current treatment options for managing heart

INTRODUCTION: High-Intensity Interval Training (HIIT) is known as one method to treat Cardiovascular Diseases (CD), such as Coronary Arterial Disease (CAD) and Heart Failure (HF), due to its potential to improve cardio respiratory fitness (1, 15). This exercise format is characterized as aerobic exercise performed in a high intensity - usually controlled by either maximum oxygen uptake or maximum heart rate – with active and low intensity. Performing exercise in high intensities mixed with active rest allows patients to tolerate a higher effort before they become tired. Heart failure patients present a diminished exercise capacity, due to a smaller Ejection Fraction (EF), which tells us how well the heart pumps blood to body. To these patients, High-Intensity Interval Training has been reported for improving Systolic Function due to the increased effort in which the heart is working (16). The necessity to provide nutrients through circulation during exercise leads to an increased contractility and consequently LV Remodeling (15). Coronary Arterial Disease Patients have a decreased blood flow to the myocardial tissue due to an obstruction inside the coronary arteries. HIIT increases the arteriovenous O2 difference, which means there is an elevated consumption of oxygen by the tissues as result of a higher stroke volume. All those benefits have been shown in the literature, but most of the studies present data with short-term interventions. A few studies discuss the benefits

The literature on the effects of exercise of cardiac output maintains the idea that exercise should affect cardiac output- pulse rate, systolic blood pressure, diastolic blood pressure, QRS-pulse lag, P-T and T-P intervals, because of increased heart rate. For our experiment, we tested this theory by measuring our cardiac output before and after some rigorous exercise. We measured the individual cardiac output and then combined the data to compose a class-wide data average. We compared the results of the experiment to what we expected, which was that exercise does affect our heart. Our data from this experiment supported the notion that exercise does, in fact, change cardiac output.

Mammals consume oxygen and produce carbon dioxide as part of their metabolism process in order to maintain body functions. This occurs at all times, both rest and during intense work, within mammals. During times of greater work, skeletal muscles work harder than they do at rest. This in turn increases their metabolic rate and results in a greater demand for oxygen. It has been proposed that fitness training has a positive effect on both the cardiovascular and respiratory systems, which effect the maximum oxygen consumption rate during intense exercise periods. I hypothesize that individuals who aerobically exercise a minimum of at least 7 hours per week will have increased fitness, which will maximize their overall metabolic rates and give them higher VO2 max and VCO2 max values than individuals who do not have increased fitness. Ten males having different fitness levels were put on stationary bikes at increasing levels until exhaustion and VO2-max and VCO2-max was then measured from each individual. It was found that there was a slight upward trend between fitness-VO2max and fitness-VCO2max, although this trend was not statistically significant when represented by the T-test values through statistical analysis. Further experiments should be done in the future to verify a statistically significant correlation.