Evidence map›Paper›PMID 19351942›Full record

Trial reportJAMA2009

Effects of exercise training on health status in patients with chronic heart failure: HF-ACTION randomized controlled trial.

Kathryn E Flynn, Ileana L Piña, David J Whellan, Li Lin, James A Blumenthal, Stephen J Ellis, Lawrence J Fine, Jonathan G Howlett, Steven J Keteyian, Dalane W Kitzman and 7 more

Erratum issued 7 registry-linked trialsAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in JAMA, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 7 registered trials, which are not on this map. Cited by 283 papers, 17 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
283citing papers in PubMed, 17 pooled it
–field-weighted citation impact
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.

NCT00047437 phase3completednot on this map

Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION)

TypeinterventionalSponsorDuke UniversityRan2003 to 2008Enrolled2,331ConditionsCardiovascular Diseases, Heart Diseases, Heart Failure, CongestiveArmsSupervised Exercise Training Program
NCT01493193 phase4completednot on this mapstarted 2011, after this paper: background citation

Effects of Different Endurance Training Protocols on Physical Performance in Cardiac Patients

TypeinterventionalSponsorParacelsus Medical UniversityRan2011 to 2013Enrolled60ConditionsCoronary Artery DiseaseArmsEndurance training with constant work load, Pyramid-Training, High-intensity interval training
NCT01540006 completednot on this map

Outpatient Cardiac Rehabilitation in Austria

TypeobservationalSponsorParacelsus Medical UniversityRan2009 to 2014Enrolled1,200ConditionsHeart DiseaseArmsPhysical activity
NCT03032081 nawithdrawnnot on this mapstarted 2017, after this paper: background citation

High Intensity Interval Training in Heart Failure: The Gold Standard of Future Patient Care

TypeinterventionalSponsorGeorgia State UniversityRan2017 to 2018Enrolled0ConditionsHeart Failure, Physical ActivityArmsHigh intensity exercise, Moderate intensity exercise
NCT04248088 naunknown statusnot on this mapstarted 2019, after this paper: background citation

Getting Into Light Exercise for Patients With Heart Failure

TypeinterventionalSponsorUniversity of VirginiaRan2019 to 2021Enrolled100ConditionsHeart FailureArmsGentle Stretching and Education
NCT06503445 nacompletednot on this mapstarted 2021, after this paper: background citation

The Impact of Video-based Cardiac Rehabilitation Education in Patients With Cardiovascular Implantable Electronic Devices(CIEDs)- a Randomized Controlled Trial

TypeinterventionalSponsorNational Taiwan University Hospital Hsin-Chu BranchRan2021 to 2022Enrolled85ConditionsPatients With Cardiac Implantable Electronic DevicesArmseducation video
NCT07023536 recruitingnot on this mapstarted 2025, after this paper: background citation

Evaluation of the Effectiveness of a Cardiac Telerehabilitation Program in Chronic Heart Failure

TypeobservationalSponsorUniversity of SalernoRan2025 to 2026Enrolled205ConditionsHeart FailureArmsTELEREHABILITATION-YES, TELEREHABILITATION-NO
3 · Its place in the literature

Who cites it

283 citing papers in PubMed, 17 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Exercise-based cardiac rehabilitation for adults with heart failure.The Cochrane database of systematic reviews · 2024
    Pooled it
  5. Guideline
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Pooled it
  11. Pooled it
  12. Pooled it
  13. Exercise-based cardiac rehabilitation for adults with heart failure.The Cochrane database of systematic reviews · 2019
    Pooled it
  14. Aerobic exercise and cardiopulmonary fitness in childhood cancer survivors treated with a cardiotoxic agent: a meta-analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2018
    Pooled it
  15. Home-based versus centre-based cardiac rehabilitation.The Cochrane database of systematic reviews · 2017
    Pooled it
  16. Guideline
  17. Guideline
  18. Trial
  19. Trial
  20. Trial

223 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

  • Erratum issued
5 · Who and what money

Authors and funding

17 authors.

Kathryn E FlynnCenter for Clinical and Genetic Economics, Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC 27715, USA. kathryn.flynn@duke.edu
Ileana L Piña
David J Whellan
Li Lin
James A Blumenthal
Stephen J Ellis
Lawrence J Fine
Jonathan G Howlett
Steven J Keteyian
Dalane W Kitzman
William E Kraus
Nancy Houston Miller
Kevin A Schulman
John A Spertus
Christopher M O'Connor
Kevin P Weinfurt
HF-ACTION Investigators

Funding

ACTION - A CHF Trial Investigating Outcomes of ExerciseU01HL063747 · NHLBI · DUKE UNIVERSITY · PI O'CONNOR, CHRISTOPHER M · 2002 to 2008
$24.8M
Exercise Intolerance in Elderly Diastolic Heart FailureR37AG018915 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI KITZMAN, DALANE W · 2005 to 2013
$3.4M
ACTION EQOL STUDYU01HL066461 · NHLBI · DUKE UNIVERSITY · PI SCHULMAN, KEVIN ALAN · 2002 to 2008
$2.7M
ACTION - A CHF Trial Investigating Outcomes of ExerciseU01HL064250 · NHLBI · HENRY FORD HEALTH SYSTEM · PI KETEYIAN, STEVEN J · 2002 to 2007
$1.4M
CHF TRIAL INVESTIGATING OUTCOMES OF EXERCISE TRAININGU01HL066491 · NHLBI · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI KITZMAN, DALANE W · 2002 to 2007
$1.4M
ACTION - A CHF Trial Investigating Outcomes of ExerciseU01HL064264 · NHLBI · WASHINGTON UNIVERSITY · PI EWALD, GREGORY A · 2002 to 2006
$1.0M
ACTION - A CHF Trial Investigating Outcomes of ExerciseU01HL068973 · NHLBI · BOSTON MEDICAL CENTER · PI COLUCCI, WILSON S. · 2002 to 2007
$1.0M
ACTION - A CHF Trial Investigating Outcomes of ExerciseU01HL066501 · NHLBI · CASE WESTERN RESERVE UNIVERSITY · PI PINA, ILEANA L · 2002 to 2007
$973k
ACTION - A CHF Trial Investigating Outcomes of ExerciseU01HL066497 · NHLBI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI BITTNER, VERA A · 2002 to 2005
$838k
ACTION - A CHF Trial Investigating Outcomes of ExerciseU01HL064257 · NHLBI · OREGON HEALTH AND SCIENCE UNIVERSITY · PI ALHARETHI, RAMI · 2002 to 2005
$773k
ACTION-A CHF TRIAL INVESTIGATING OUTCOMES OF EXERCISEU01HL066494 · NHLBI · OHIO STATE UNIVERSITY · PI ABRAHAM, WILLIAM TOBER · 2002 to 2005
$766k
ACTION - A CHF Trial Investigating Outcomes of ExerciseU01HL068980 · NHLBI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI FONAROW, GREGG C · 2002 to 2006
$709k
NHLBI NIH HHS 5U01HL063747NHLBI NIH HHS 5U01HL064250NHLBI NIH HHS 5U01HL064257NHLBI NIH HHS 5U01HL064264NHLBI NIH HHS 5U01HL064265NHLBI NIH HHS 5U01HL066461NHLBI NIH HHS 5U01HL066482NHLBI NIH HHS 5U01HL066491NHLBI NIH HHS 5U01HL066494NHLBI NIH HHS 5U01HL066497NHLBI NIH HHS 5U01HL066501NHLBI NIH HHS 5U01HL068973NHLBI NIH HHS 5U01HL068980NHLBI NIH HHS U01 HL063747NHLBI NIH HHS U01 HL064250NHLBI NIH HHS U01 HL064257NHLBI NIH HHS U01 HL064264NHLBI NIH HHS U01 HL064265NHLBI NIH HHS U01 HL066461NHLBI NIH HHS U01 HL066482NHLBI NIH HHS U01 HL066491NHLBI NIH HHS U01 HL066494NHLBI NIH HHS U01 HL066497NHLBI NIH HHS U01 HL066501NHLBI NIH HHS U01 HL068973NHLBI NIH HHS U01 HL068980NIA NIH HHS R37 AG018915
6 · The paper itself

Abstract

contextFindings from previous studies of the effects of exercise training on patient-reported health status have been inconsistent.

objectiveTo test the effects of exercise training on health status among patients with heart failure. DESIGN, SETTING, AND PATIENTS: Multicenter, randomized controlled trial among 2331 medically stable outpatients with heart failure with left ventricular ejection fraction of 35% or less. Patients were randomized from April 2003 through February 2007.

interventionsUsual care plus aerobic exercise training (n = 1172), consisting of 36 supervised sessions followed by home-based training, vs usual care alone (n = 1159). Randomization was stratified by heart failure etiology, which was a covariate in all models.

main outcome measuresKansas City Cardiomyopathy Questionnaire (KCCQ) overall summary scale and key subscales at baseline, every 3 months for 12 months, and annually thereafter for up to 4 years. The KCCQ is scored from 0 to 100 with higher scores corresponding to better health status. Treatment group effects were estimated using linear mixed models according to the intention-to-treat principle.

resultsMedian follow-up was 2.5 years. At 3 months, usual care plus exercise training led to greater improvement in the KCCQ overall summary score (mean, 5.21; 95% confidence interval, 4.42 to 6.00) compared with usual care alone (3.28; 95% confidence interval, 2.48 to 4.09). The additional 1.93-point increase (95% confidence interval, 0.84 to 3.01) in the exercise training group was statistically significant (P < .001). After 3 months, there were no further significant changes in KCCQ score for either group (P = .85 for the difference between slopes), resulting in a sustained, greater improvement overall for the exercise group (P < .001). Results were similar on the KCCQ subscales, and no subgroup interactions were detected.

conclusionsExercise training conferred modest but statistically significant improvements in self-reported health status compared with usual care without training. Improvements occurred early and persisted over time.

trial registrationclinicaltrials.gov Identifier: NCT00047437.

Indexed as

Exercise TherapyHealth StatusQuality of LifeAgedAmbulatory CareChronic DiseaseExerciseExercise TestFemaleHeart FailureHumansMaleMiddle AgedSelf CareSickness Impact ProfileTreatment Outcome

Identifiers

PMID19351942
PMCPMC2690699

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

and 1 more above

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.