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Study may explain why exercise helps heart failure patients

(BETHESDA, MD) Aerobic training is associated with a reversal of abnormal hormonal patterns that underlie many of the debilitating symptoms of heart failure, according to a new study in the May 2, 2006, issue of the Journal of the American College of Cardiology.

"A feasible home-based and progressively adjusted aerobic training strategy is able to overcome the limitation of pharmacological treatment in antagonizing neurohormonal activation in heart failure patients, likely contributing to a significant improvement in quality of life, and possibly to the positive prognostic effects," said Claudio Passino, M.D. from the CNR Institute of Clinical Physiology in Pisa, Italy.

It is well-known that exercise training helps many heart failure patients feel better and improves their ability to function more normally. This study indicates that aerobic training may produce these benefits by reversing the abnormal production of certain neurohormones that result in many of the severe symptoms of heart failure.

After a heart attack or other cardiac event, the body responds by increasing the production of B-type natriuretic peptide (BNP). This neurohormonal activation, as it is called, helps the heart continue to pump blood in the short run by constricting blood vessel and retaining sodium in cardiac cells.

"This neurohormonal imbalance becomes detrimental on the long-term, promoting left ventricular fibrosis, dilatation, arrhythmias, peripheral tissue hypoperfusion, edemas, and thus leading to a symptomatic disease with dyspnea and fatigue," Dr. Passino said.

Previous studies indicated that patients with higher levels of B-type natriuretic peptide have poorer prognoses. Drug treatments are often unable to adequately reverse the neurohormonal activation.

Since physical activity often helps heart failure patients, the researchers wanted to find out what effect aerobic training has on the
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Contact: Amy Murphy
amurphy@acc.org
301-581-3476
American College of Cardiology
26-Apr-2006


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