Evidence map›Paper›PMID 1591831›Full record

Trial reportCirculation1992

Controlled trial of physical training in chronic heart failure. Exercise performance, hemodynamics, ventilation, and autonomic function.

A J Coats, S Adamopoulos, A Radaelli, A McCance, T E Meyer, L Bernardi, P L Solda, P Davey, O Ormerod, C Forfar

2 registry-linked trialsOpen access · bronzeAbstract readClinical TrialComparative StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Circulation, 1992. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 211 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
211citing papers in PubMed, 13 pooled it
45.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04425785 nacompletednot on this mapstarted 2019, after this paper: background citation

Physical Exercise and Mental Wellbeing Rehabilitation for Acute Stress-induced Takotsubo Cardiomyopathy: The PLEASE Study

TypeinterventionalSponsorUniversity of AberdeenRan2019 to 2023Enrolled76ConditionsTakotsubo CardiomyopathyArmsPhysical Exercise Program, Cognitive Behavioural Therapy
NCT04467411 active not recruitingnot on this mapstarted 2020, after this paper: background citation

Randomised Controlled Study of Physical Exercise Intervention in Breast Cancer Patients at Risk of Anthracycline-induced Cardiomyopathy:The EMBRACE Study

TypeobservationalSponsorUniversity of AberdeenRan2020 to 2030Enrolled70ConditionsBreast Cancer
3 · Its place in the literature

Who cites it

211 citing papers in PubMed, 13 syntheses or guidelines pooled it, 949 citations in OpenAlex.

  1. Pooled it
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  3. Physical activity interventions for people with congenital heart disease.The Cochrane database of systematic reviews · 2020
    Pooled it
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  5. Exercise-based cardiac rehabilitation for adults with heart failure.The Cochrane database of systematic reviews · 2019
    Pooled it
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  11. Exercise-based rehabilitation for heart failure.The Cochrane database of systematic reviews · 2014
    Pooled it
  12. Exercise based rehabilitation for heart failure.The Cochrane database of systematic reviews · 2004
    Pooled it
  13. Exercise training and heart failure: a systematic review of current evidence.The British journal of general practice : the journal of the Royal College of General Practitioners · 2002
    Pooled it
  14. Trial
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151 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

A J CoatsDepartment of Cardiac Medicine, National Heart and Lung Institute, London, UK.
S Adamopoulos
A Radaelli
A McCance
T E Meyer
L Bernardi
P L Solda
P Davey
O Ormerod
C Forfar

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMany secondary abnormalities in chronic heart failure (CHF) may reflect physical deconditioning. There has been no prospective, controlled study of the effects of physical training on hemodynamics and autonomic function in CHF. METHODS AND

resultsIn a controlled crossover trial of 8 weeks of exercise training, 17 men with stable moderate to severe CHF (age, 61.8 +/- 1.5 years; left ventricular ejection fraction, 19.6 +/- 2.3%), increased exercise tolerance (13.9 +/- 1.0 to 16.5 +/- 1.0 minutes, p less than 0.001), and peak oxygen uptake (13.2 +/- 0.9 to 15.6 +/- 1.0 ml/kg/min, p less than 0.01) significantly compared with controls. Training increased cardiac output at submaximal (5.9-6.7 l/min, p less than 0.05) and peak exercise (6.3-7.1 l/min, p less than 0.05), with a significant reduction in systemic vascular resistance. Training reduced minute ventilation and the slope relating minute ventilation to carbon dioxide production (-10.5%, p less than 0.05). Sympathovagal balance was altered by physical training when assessed by three methods: 1) RR variability (+19.2%, p less than 0.05); 2) autoregressive power spectral analysis of the resting ECG divided into low-frequency (-21.2%, p less than 0.01) and high-frequency (+51.3%, p less than 0.05) components; and 3) whole-body radiolabeled norepinephrine spillover (-16%, p less than 0.05). These measurements all showed a significant shift away from sympathetic toward enhanced vagal activity after training.

conclusionsCarefully selected patients with moderate to severe CHF can achieve significant, worthwhile improvements with exercise training. Physical deconditioning may be partly responsible for some of the associated abnormalities and exercise limitation of CHF, including abnormalities in autonomic balance.

Indexed as

Exercise TherapyAutonomic Nervous SystemElectrocardiographyExercise TestHeart FailureHemodynamicsHumansMaleMiddle AgedNorepinephrinePulmonary Gas ExchangeSignal Processing, Computer-AssistedNorepinephrine

Identifiers

PMID1591831
OpenAlexW2003464319

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.