Heart failure Exercise could help at the first signs

(Montreal) Physical activity could help patients who show the first signs of a form of heart failure, but who do not yet experience symptoms, to stay healthy longer, shows a new American study.

Posted Sep 30, 2021Jean-Benoit Legault The Canadian Press

Researchers from the University of Texas were interested in patients who suffer from heart failure with preserved ejection fraction. The heart of these patients pumps with normal force, although it is not able to relax adequately to fill with blood.

Patients may experience water accumulation on the lungs or legs and shortness of breath. Physicians are currently very limited in their ability to slow the inexorable progression of the disease.

The American researchers, however, found that patients who were the most physically active managed to improve the "elasticity" of their heart muscle, and therefore delay the onset of symptoms.

"It's huge," enthused Dr. François Simard, of the Montreal Heart Institute. When I go to see a patient who seems to have a bit of that profile, then unfortunately we see them frequently, it's clear that I'm even more going to recommend that they do physical exercise on a regular basis. »

Thirty-one patients participated in the Texas study. Eleven did yoga, balance exercises and strength exercises three times a week; the other twenty-one swam, cycled or walked until they were able to do 30 minutes of vigorous interval aerobic activity twice a week, in addition to a few weekly workouts. moderate intensity and strength exercises.

Insuffisance cardiaque L’exercice pourrait aider dès les premiers signes

After one year, members of the more physically active group had improved heart muscle elasticity and cardiorespiratory health. No changes were seen in the control group.

The subjects were sedentary men and women between the ages of 45 and 64.

"A study like this that says, 'OK, there really was an improvement in the heart's ability to relax', and then potentially that could have an impact in the future to be demonstrated, that pleases the mind," said Simard Dr. I think that gives us even more arguments to encourage patients in that direction. »

Limited Arsenal

When faced with such patients, doctors now look for other health conditions that could be causing heart failure, such as high blood pressure, and recommend lifestyle changes, such as salt intake. . They may also prescribe medications to combat water buildup, but these eventually lose effectiveness over time.

Treating the underlying causes of the problem can help curb the disease a little, but "it's a process that is somewhat inevitable, which will progress, progress, progress, and then eventually patients will have symptoms and unfortunately die" , lamented Dr. Simard.

It is therefore “innovative” to note that physical exercise has a role to play, he adds, since it adds a weapon to the therapeutic arsenal of doctors.

The results of this study do not currently allow us to determine whether patients who have improved heart muscle health will also eventually experience the symptoms of their heart failure.

However, in another study, the same researchers had found that physical activity did not improve the fate of patients over 65 who were already showing symptoms. This is why they decided to intervene with younger patients and for the moment asymptomatic.

The challenge for doctors now will be to convince patients to move after being told that their heart health is starting to fail, Dr. Simard admitted.

“It's very common,” he replies when asked if the patients he sees daily are hesitant to become more physically active, for fear of asking too much of their hearts.

For a long time, he said, the message was to stay in bed and strain as little as possible. All these myths have now been debunked, but there is still a lot of educational work to be done on the part of doctors.

“More and more, we realize that even if the heart has been damaged and everything, (within) certain markers, doing physical exercise is almost always beneficial when you have a heart problem. “, indicated Dr. Simard.

Even in the case of cardiac pathologies for which it was believed that physical exercise was absolutely contraindicated, we now realize that we can derive a benefit from cardiac activity, he added.

The findings of this study were recently published by Circulation, the medical journal of the American Heart Association.

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