Impact of Exercise Training and Depression on Survival in Heart Failure Due to Coronary Heart Disease Article

Full Text via DOI: 10.1016/j.amjcard.2010.08.047 PMID: 21146688 Web of Science: 000286126900012

Cited authors

  • Milani, Richard V.; Lavie, Carl J.; Mehra, Mandeep R.; Ventura, Hector O.


  • Depression is prevalent in patients with heart failure (HF) and is associated with increased mortality. In patients with coronary heart disease (CHD) without HF, exercise training (ET) can effectively decrease depressive symptoms resulting in improved survival. We evaluated 189 patients with American College of Cardiology/American Heart Association stage C HF due to CHD (mean left ventricular ejection fraction 35 +/- 10%) enrolled in a structured ET program from January 2000 to December 2008, including a group of 151 who completed the program and 38 patients with HF who dropped out of rehabilitation without ET. Depressive symptoms were assessed by standard questionnaire at baseline and after ET, and mortality was determined at a mean follow-up of 4.6 +/- 2.6 years. Prevalence of depressive symptoms decreased by 40% after ET, from 22% to 13% (p < 0.0001). Patients initially classified as depressed who remained depressed after ET had nearly a fourfold higher mortality than patients whose depression resolved after ET (43% vs 11%, p = 0.005). Depressed patients who completed ET had a 59% lower mortality (44% vs 18%, p < 0.05) compared to depressed dropout subjects not undergoing ET. Survival benefits after ET were concentrated to those patients with depression who improved exercise capacity. In conclusion, depressive symptoms are prevalent in patients with HF and are associated with increased mortality. Structured ET is effective in decreasing depressive symptoms, a factor that correlates with improved long-term survival. (c) 2011 Published by Elsevier Inc. (Am J Cardiol 2011;107:64-68)

Publication date

  • 2011

Published in

International Standard Serial Number (ISSN)

  • 0002-9149

Start page

  • 64

End page

  • 68


  • 107


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