Back ground: The positive effects of physical training in patients with chronic heart failure (CHF) are reflected in improving exercise tolerance, reduce symptoms and less hospitalization, increasing survival and improving quality of life. Elderly patients have more advanced CHF than younger because they tend to be more sedentary and thus do not note symptoms or do not receive a diagnosis of CHF until their cardiac limitation is advanced. In elderly patients with heart failure are often present anemia and chronic renal failure, which further affect the tolerance of physical exertion.
Objective: To evaluate the effects of short-term physical training on exercise tolerance and value of renal and hematological parameters in elderly patients with CHF.
Patients and Methods: The study involved 78 patients (52 males), with coronary artery disease, mean EF 34.05 ± 3.24%, NYHA II and III, without anemia and/or chronic kidney disease. All patients were included in three-week rehabilitation program at the residential center, with individually prescribed physical training. Before and after rehabilitation, all patients underwent exercise stress test, and from the veins blood samples renal and hematological parameters were measured. In relation to age, patients were divided into three groups: A (<60 yrs: n = 29), B (60-69 yrs; n = 36) and C (≥70 yrs;n = 13).
Results: After rehabilitation, only in group C significantly lower serum creatinine (p = 0.028) was registered, compared to the value before rehabilitation. In groups A and B, there was a decreasing trend of creatinine, but without significance. Serum urea and uric acid in all groups after rehabilitation, showed no significant change. It was also shown that after rehabilitation, only in group B there was a significant reduction in the number of leukocytes (p = 0.037). Other hematologic parameters did not show significant changes. Exercise tolerance improved in all groups (p < 0.001 for all). After the rehabilitation in group C, heart rate at rest, was substantially lower than in the group A and B (p = 0.003).
Conclusion: Residential short-term physical training led to reduction of serum creatinine in the oldest patients (≥70yrs) with heart failure. Reduction of leukocytes is more pronounced in patients aged 60-69. The largest reduction in heart rate at rest was achieved in patients older than 70 years.