摘要
Exercise is an important behavior for long-term weight control in overweight and obese patients. However, little evidence exists confirming such findings in patients with advanced heart failure(HF). Using a prospective, experimental design, the effects of 24 weeks of a low-level, home-based walking program on weight loss were studied in overweight and obese(body mass index≥ 27 kg/m2) patients with advanced HF who were randomized to exercise(n=48) and control(n=51) groups. Weight changes between the 2 groups at baseline and 6 months were compared using repeated-measures analysis of variance. Patients were on average aged 53.3± 10.1 years and predominantly male(75% ), Caucasian(57% ), and married(55% ). Most patients were in New York Heart Association class III or IV(67% ), with a mean ejection fraction of 25% . Patients in the exercise group showed significant weight reduction from baseline to 6 months compared with those in the control group(-6.37± 11.7 vs -0.33± 9.3 kg, p=0.002). No significant differences were noted between the 2 groups in 6-minute walk distance or depression, although the changes were in the anticipated direction. Modest weight losses of >5% were associated with cardiopulmonary exercise test-documented workload levels at 6 months(r=0.331, p=0.006), as well as decreased depression(r=-0.315, p=0.01) and hostility(r=-0.355, p=0.005). The number of hospital admissions was significantly smaller for patients in the exercise group compared with those in the control group(0.63± 0.94 vs 1.07± 0.95, p< 0.05). In conclusion, the findings demonstrate the beneficial effects of a low-level, home-based walking program on weight loss in overweight and obese patients with advanced HF.
Exercise is an important behavior for long-term weight control in overweight and obese patients. However, little evidence exists confirming such findings in patients with advanced heart failure（HF）. Using a prospective, experimental design, the effects of 24 weeks of a low-level, home-based walking program on weight loss were studied in overweight and obese（body mass index ≥ 27 kg/m^2） patients with advanced HF who were randomized to exercise （n = 48） and control（n = 51） groups. Weight changes between the 2 groups at baseline and 6 months were compared using repeated-measures analysis of variance. Patients were on average aged 53.3 ± 10. 1 years and predominantly male （75%）, Caucasian（57% ）, and married（55% ） Most patients were in New York Heart Association class III or IV （67%）, with a mean ejection fraction of 25%. Patients in the exercise group showed significant weight reduction from baseline to 6 months compared with those in the control group（-6.37±11.7 vs -0.33±9.3 kg, p=0.002） . No significant differences were noted between the 2 groups in 6-minute walk distance or depression, although the changes were in the anticipated direction. Modest weight losses of 〉 5% were associated with cardiopulmonary exercise test-documented workload levels at 6 months（r= 0. 331, p =0.006）, as well as decreased depression（r= -0.315, p=0.01） and hostility（r=-0.355, p= 0. 005） . The number of hospital admissions was significantly smaller for patients in the exercise group compared with those in the control group（0.63 ±0.94 vs 1.07 ± 0.95, p 〈 0. 05）. In conclusion, the findings demonstrate the beneficial effects of a low-level, home-based walking program on weight loss in overweight and obese patients with advanced HF.
