Table 1 Randomized controlled parallel group trials of exercise training in patients with impaired left ventricular function

Jette 1991 [17]

1. LVEF < 30%   Control n = 10

Supervised in hospital for 4 weeks a.m. - run 5 min × 3/

LVEF < 30% group

ExT n = 8

Peak VO₂ increased by 221 ml/min (P < 0.05)

Peak WL increased by 13 W (P < 0.05)

2. LVEF 31–50%

week at 70–80% max HR calisthenics 30 min cycle 15 min at 70–80% max HR p.m. - walk (graded paths) 30–60 min

LVEF 31–50% group

Control n = 10

Peak VO₂ increased by 85 ml/min (P = NS)

ExT n = 11

Peak WL increased by 9 W (P = NS)

Koch 1992 [15]

1. ExT n = 12

40 sessions over 90 days, graded program

QOL score increased by 52% (P < 0.0001)

2. Control n = 13

Belardinelli 1992 [18]

1. ExT n = 10

Supervised 8 week program Cycle at 60% VO_2peak × 3/week

Ex tolerance increased by 45% (P < 0.005)

2. Control n = 10

Peak O₂ uptake increased by 20% (P < 0.001)

Kostis 1994 [19]

1. Placebo n = 6

12 week program Walk/row/cycle/stair climb 60 min × 3–5/week at 50–60% max HR Cognitive behavioral sessions Diet modification

Ex tolerance increased by 182 s (P < 0.05)

2. Digoxin n = 7

3. ExT n=7

Kiilavuori 1995 [20]

1. ExT n = 8

Supervised for 3 months Cycle 30 min × 3/week at 50–60% max VO₂

Ex tolerance increased by 71% at submaximal WL (P = 0.01)

2. Control n = 12

High frequency component of HR variability increased by 22–55% during the day

(P = 0.0001)

Hambrecht 1995 [21]

1. ExT n= 12

Supervised for 3 weeks 10 min × 6/day at 70% max VO₂ then home-based until 6 months: cycle 40 min/day at 70% max VO₂ walk/calisthenics/ball games 60 min × 2/week

Peak VO₂ increased by 12% (P < 0.001)

2. Control n=10

Muscle mitochondria volume density increased (P < 0.05)

Belardinelli 1995 [22]

1. ExT n = 36

Supervised in hospital Calisthenics warm up 15 min × 3/week Cycle 40 min × 3/week at 60% max VO₂

Peak VO₂ increased by 12% (P < 0.001)

2. Control n = 19

Improved indices of diastolic function

Hambrecht 1997 [23]

1. Ext n = 9

Supervised for 3 weeks 10 min × 6/day at 70% max VO₂ then home-based until 6 months: cycle 40 min/day at 70% max VO₂ walk/calisthenics/ball games 60 min × 2/week

Enhanced oxidative enzyme activity and improved

2. Control n= 9

mitochondrial size and number of cistae in skeletal muscle biopsies

Dubach 1997 [24]

1. ExT n = 12

Supervised for 8 weeks Walk 60 min × 2/day Cycle 40 min × 4/week at 80% max VO₂

Peak VO₂ uptake increased

2. Control n = 13

Peak WL increased

Ex time increased

Reinhart 1998 [25]

n = 25

8 week residential program Cycle 40 min at 70–80% maximal exercise capacity × 4/week and walk 2 × 1 h/day

Increased maximal cardiac output and peak O₂ uptake

Wielanger 1998,

1. ExT n = 41

Supervised for 12 weeks 3 × 10 min cycle/walk/ball games 5 min rest Exercise at target heart rate (resting HR + 60% difference between resting and maximum HR)

Feelings of being disabled decreased as shown by?

1999 [26,27]

2. Control n = 39

Self-Assessment of General Well-Being (SAGWB)

Ex time increased by 21.4% (P < 0.0001)

Anaerobic threshold increased by 12.5% (P < 0.05)

Peak O₂ uptake not significantly changed

Callaerts-Vegh

1. ExT n = 9

8 weeks intensive training

Peak O₂ uptake increased by 30.9%

1998 [28]

2. Control n = 8

Urinary nitrate elimination decreased in controls but unchanged in ExT group

Willenheimer 1998 [29]

1. ExT n = 22

Supervised for 16 weeks. Interval training: cycle 60 s at 80% VO_2max then 30 s rest week 0–7 15 min × 2/week week 7–16 45 min × 3/week

Peak ex WL increased by 7 W (P < 0.01)

2. Control n = 27

Belardinelli 1999 [16]

1. ExT n = 50

Supervised 8 week program Cycle at 60% VO_2peak × 3/week Supervised 12 month maintenance program: 2 sessions/week: 20 min stretching exercises; 40 min cycle

Peak O₂ uptake increased by 18% at 2 months (P < 0.001)

2. Control n = 49

Lower mortality (n=9 versus n = 20, RR=0.37; 95% CI, 0.17 to 0.84; P = 0.01)

Fewer hospital readmissions for heart failure (5 versus 14; RR=0.29; 95% CI,

0.11 to 0.88; P = 0.02)

Sturm 1999 [30]

n = 26

12 weeks of 50% maximal exercise capacity training progressing to 100 min step aerobics/week and 50 min cycle/week

Peak O₂ uptake increased by 23.3% (P = 0.001

Peak WL increased by 26% (P = 0.0001)

Keteyian 1999 [31]

1. ExT n = 21

Warm up 5 min, cool down 11 min 33 min × 3/week at 60–80% max HR (11 min × 3 ergometers: cycle, row, arm, treadmill) × 24 weeks

Peak O₂ uptake increased (P < 0.05)

2. Control n = 22

Improved chronotropic response to exercise

Quittan 1999 [32]

1. n = 25

Aerobics 3 h/week

Improved QOL (P = 0.0001), physical role fulfillment (P = 0.001), physical (P = 0.02)

and social (P = 0.0002) functioning

Peak O₂ uptake and ex time increased (P < 0.01)

Hambrecht 2000 [33]

1. ExT n = 36

2 weeks × 10 min cycle 4–6/week followed by 6 months home-based cycle × 20 min at 70% peak O₂ uptake

NYHA class improved

2. Control n = 37

Ex time increased

LVEF increased from 0.30 to 0.35 (P = 0.003)

Peak ex TPR decreased (P = 0.003)