Effect of Passive Exercise on Systemic Endothelial Function in Elderly Patients With Chronic Heart Failure

• Left ventricular systolic and diastolic function [ Time Frame: 2 weeks ] [ Designated as safety issue: Yes ]
• Six-minute walk distance [ Time Frame: 2 weeks ] [ Designated as safety issue: Yes ]

The purpose of this study is to determine the effect of passive exercise on systemic endothelial function in elderly patients with chronic heart failure.

Endothelial function is known to be impaired in patients with chronic heart failure (CHF) and impaired endothelial function has been reported to be associated with an increased mortality risk in those subjects. Although systemic exercise training has been demonstrated to improve endothelial dysfunction in patients with CHF, elderly patients with severely impaired exercise capacity could not engaged in usual exercise training using ordinal ergometer. Those patients are able to join stretching or very light resistance training. On the other hand, passive pedaling using strength ergometer has been reported to be useful in patients with severely impaired exercise capacity, but the safety and the efficacy of passive pedaling on endothelial function in old patients with CHF has not been previously reported.

• Congestive Heart Failure
• Endothelium-Derived Factors
• Elderly

• Other: Passive leg cycle exercise with stretching and resistance training
  Passive leg cycle exercise for 15 minutes everyday as well as stretching and resistance training
• Other: Stretching and resistance training
  Stretching and resistance training everyday but no Passive leg cycle exercise

• Active Comparator: 1
  Passive leg cycle exercise with stretching and resistance training
  Intervention: Other: Passive leg cycle exercise with stretching and resistance training
• Active Comparator: 2
  Stretching and resistance training
  Intervention: Other: Stretching and resistance training

Inclusion Criteria:

• Clinical diagnosis of chronic heart failure
• Elderly patients aged ≧65 years
• Patients with severely reduced exercise capacity and cannot continue exercise with usual cycling ergometer for 5 minutes

Exclusion Criteria:

• Unstable hemodynamic status (uncontrolled arrhythmia, uncontrolled congestion, uncontrolled hypertension)
• Active infectious disease
• Malignancy
• Chronic obstructive pulmonary disease
• Dialysis
• Severe aortic valve disease
• With any hip, knee, ankle joint pain
• Hemiplegia
• Current smoker