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박찬수,박진주,오일영,윤창환,최동주,박현아,강석민,유병수,전은석,김재중,조명찬,채성철,유규형,오병희,behalf of the KorHF Investigators 대한심장학회 2017 Korean Circulation Journal Vol.47 No.5
Background and Objectives Although many clinical trials have shown that exercise training (ET) improves functional capacity and clinical outcomes in heart failure (HF) patients, data comparing supervised hospital-based and educated home-based ET in HF patients is lacking. Subjects and Methods This was a single-center, non-randomized, prospective study of 82 HF patients with reduced ejection fraction (≤40%) who completed ET. The hospital-based group (n=30) underwent supervised ET at 60% of peak oxygen consumption (VO2), while a physiotherapist-educated group (n=52) exercised at home without monitoring. The 2 groups were compared before and after the 3-month ET program with respect to functional capacity, quality of life (QOL), and cardiac events (all-cause mortality or hospitalization with worsening HF). Results After ET, peak VO2 increased in the hospital-based group (19.4±4.4 to 21.4±4.3 mL/min/kg, p=0.006) and remained unchanged in the home-based group (18.9±4.6 to 18.4±4.6 mL/min/kg, p=0.660). The change in peak VO2 after ET was greater in the hospital-based group compared to the home-based group by 2.5 mL/min/kg (p=0.014). QOL improved in the hospital-based group (43.1±18.0 to 28.1±21.6, p=0.003). During one year of follow-up, a comparison of the 2 groups did not reveal a statistical difference in cardiac events (hazard ratio, 0.66; 95% confidence interval, 0.2–2.8; p=0.570). Conclusion Hospital-based ET was beneficial for HF patients, improving functional capacity and QOL. However, no significant advantages were observed in terms of a composite endpoint compared to home-based ET. Further investigations are required to address the effects and roles of the 2 ET programs for HF patients