Rehabilitation of patients with congestive heart failure with or without β-blockade therapy

Background: Management of heart failure includes β-blockade (βB) therapy and cardiac rehabilitation. The aim of this study was to compare the exercise training response of patients with congestive heart failure (CHF) receiving βB therapy with that of patients not receiving treatment. Methods and Results: Thirty-four consecutive patients with CHF were included in a 4-week training program at their ventilatory threshold (VT); 6 patients received βB treatment and 18 did not. The patients underwent a cardiopulmonary exercise test before and after training. Oxygen uptake (VO2) at peak exercise and at VT increased in both groups (P ≤.0001) without any significant differences between the groups. The same results were found after adjustment to ejection fraction and VO2 at the start of the training program. There was no difference in VT improvement, measured as a percentage of utilization of maximal oxygen uptake, between the groups. After training, heart rate and ventilation decreased (P ≤.0001) at submaximal levels in both groups without significant differences between the groups. Conclusions: βB therapy does not impair functional improvement induced by a rehabilitation program in patients with CHF. βB therapy does not interfere with exercise training prescription if patient exercise evaluations are made at the time of therapeutic intake.