Exercise training in patients with stable chronic heart failure: Effects on thoracic impedance cardiography and B-type natriuretic peptide

PURPOSE: Recent evidence has suggested that patients with stable chronic heart failure (CHF) may respond favorably to a progressive exercise program. The use of noninvasive hemodynamic monitoring and B-type natriuretic peptide (BNP) measurement in these patients is not well reported. This study investigated the utility of noninvasive hemodynamic monitoring and point-of-care BNP in a cardiac rehabilitation outpatient setting. METHODS: Patients with stable CHF were assigned to a supervised 12-week exercise program (n = 13) or control (n = 6). At baseline and at the end of the study period, patients were assessed for functional and quality-of-life status. Point-of-care BNP and noninvasive hemodynamic parameters were also obtained. RESULTS: As expected, patients assigned to the exercise group showed significant improvement in quality of life and distance covered by the 6-minute walk test, but control subjects showed no such changes. There was a trend toward improved BNP in the exercise group, with 73% of these patients showing a decrease in comparison with 67% of controls showing an increase. There was a significant improvement in stroke volume in the exercise group but not in the control group. CONCLUSIONS: Both BNP and noninvasive hemodynamic monitoring can be utilized in the cardiac rehabilitation outpatient setting and seem to mirror the favorable response to exercise of other functional tests.