Changes in Heart Function in Patients with Heart Failure after the Completion of Land-Based and Partial Water-Based Exercise Programmes

Background: Opinion is divided as to the changes in ventricular function brought about by exercise, with few studies on water-based exercise programmes for heart-failure patients. This study investigates whether following a partial water-based exercise programme could lead to an earlier improvement in ventricular function in heart-failure patients compared with a land-based exercise programme.
Methods: The randomized clinical trial involved 24 heart-failure patients (ejection fraction <40%, functional class II or III), who participated in two exercise programmes (land-based or partial water-based) lasting three weeks.
Results: We observed an increase in ejection fraction (2.19±0.77 %; p=0.009), posterior wall thickness (0.79±0.23 mm; p=0.002) and mitral A wave duration (7.38±2.56 ms; p=0.009) and a decrease in the difference in duration between the pulmonary A wave period and the mitral A wave one (-5.33±2.50 ms; p=0.043) in both groups after the exercise programme had been completed. We also saw a significant increase in plasma nitrate concentration levels. Only the ratio of peak E wave (early or rapid-filling) velocity to early diastolic flow propagation velocity, the diameter of the inferior vena cava and the thickness of the posterior wall give different results depending on the exercise programme followed.
Conclusions: Changes in ventricular function show early improvement in systolic and diastolic function independently of the type of exercise, but it seems to be that, depending on the design of the programme, different adaptive mechanisms are set in motion.

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