Comparison of supervised hospitalbased versus educated home-based exercise training in Korean heart failure patients

Abstract

Background and Objectives: Although many clinical trials have shown that exercise training (ET) improves functional capacity and clinical outcomes in heart failure (HF) patients, data comparing supervised hospital-based and educated home-based ET in HF patients is lacking. Subjects and Methods: This was a single-center, non-randomized, prospective study of 82 HF patients with reduced ejection fraction (=40%) who completed ET. The hospital-based group (n=30) underwent supervised ET at 60% of peak oxygen consumption (VO2), while a physiotherapist-educated group (n=52) exercised at home without monitoring. The 2 groups were compared before and afer the 3-month ET program with respect to functional capacity, quality of life (QOL), and cardiac events (all-cause mortality or hospitalization with worsening HF). Results: Afer ET, peak VO2 increased in the hospital-based group (19.4±4.4 to 21.4±4.3 mL/ min/kg, p=0.006) and remained unchanged in the home-based group (18.9±4.6 to 18.4±4.6 mL/min/kg, p=0.660). The change in peak VO2 afer ET was greater in the hospital-based group compared to the home-based group by 2.5 mL/min/kg (p=0.014). QOL improved in the hospital-based group (43.1±18.0 to 28.1±21.6, p=0.003). During one year of follow-up, a comparison of the 2 groups did not reveal a statistical di?erence in cardiac events (hazard ratio, 0.66; 95% confdence interval, 0.2'2.8; p=0.570). Conclusion: Hospital-based ET was benefcial for HF patients, improving functional capacity and QOL. However, no signifcant advantages were observed in terms of a composite endpoint compared to home-based ET. Further investigations are required to address the e?ects and roles of the 2 ET programs for HF patients.