Favourable effects of cardiovascular rehabilitation on funcional capacity and autonomic balance in elderly patients with heart failure

In 42 patients with chronic heart failure we evaluated left ventricular function, exercise capability and autonomic control before and 3 months after a program of cardiovascular rehabilitation. The results were analyzed separately for younger (Group 1, n=18, age 51 +/- 6 years) and older patients (Group 2, n=24, age 68 +/- 4 years), with comparable clinical characteristics and therapy. Before rehabilitation, compared to younger patients, Group 2 patients showed a lower exercise capability, a comparable left ventricular ejection fraction and similar high sympathetic activity at rest, with no response to regular breathing (= stimulation of cardiopulmonary receptors, i.e. parasympathetic challenge) and active standing (= sympathetic stimulation). After rehabilitation, in both groups a 20% improvement of exercise tolerance and aerobic performance was observed, as well as a slightly increase of left ventricular ejection fraction (about 10%), and a recovery in vagal and sympathetic responsiveness. Thus, in heart failure patients age does not hinder the favorable clinical and autonomic modulation induced by cardiovascular rehabilitation.