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Evidence-based approach to exercise prescription in chronic heart failure
  1. Steve E Selig1,
  2. David L Hare2
  1. 1Centre for Ageing, Rehabilitation, Exercise and Sport (CARES), Victoria University, Melbourne, Victoria, Australia
  2. 2Department of Cardiology, Austin Health, University of Melbourne, Melbourne, Victoria, Australia
  1. Correspondence to:
 Dr S E Selig
 Centre for Ageing, Rehabilitation, Exercise and Sport (CARES), Victoria University, Melbourne, Victoria 8001, Australia; steve.selig{at}

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The benefits of moderate exercise appear to outweigh the risks

The hallmark symptoms of chronic heart failure (CHF) are fatigue and breathlessness, leading to impaired quality of life and capacity for activities of daily living (ADLs). Exercise training has the potential to delay the onset of fatigue and breathlessness, not just in patients with CHF, but in all people who exercise regularly. However, cardiologists have been concerned with recommending exercise to their patients with CHF, owing to perceptions that habitual exercise training may accelerate the disease process via cardiac hypertrophy and remodelling, deterioration in central haemodynamics and neurohormonal overactivity. All of these have strong associations with increased morbidity and mortality in these patients. A further concern has been that of sudden death from exercise-induced arrhythmias and, to a lesser extent, severe perturbations in blood pressure. Exercise training in patients with CHF is a relatively recent development, and studies to date have generally been limited to clinically stable, younger (<65 years) and less complicated cases.1 Very few women have been studied. The mortality outcome data so far are limited to less than 20 studies of a total of approximately 1000 individuals. The purpose …

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  • Published Online First 8 February 2007

  • Competing interests: None declared.