Impact of controlled physical training on clinicopathological and psychophysiological features of patients with chronic heart failure and type 2 diabetes

Abstract

Aim. To evaluate the effectiveness of long-term (five-year) supervised physical exercise in patients with chronic heart failure (CHF) following myocardial infarction (MI) and type 2 diabetes mellitus (T2DM).Materials and Methods. The study included 88 patients with CHF of functional class II-III after MI and concomitant T2DM. In addition to standard medication therapy, patients in the main group (n = 42) performed regular moderate-intensity physical exercises for 30−60 minutes at least 5 days a week. The control group consisted of 46 patients who received standard medication therapy. Patients in both groups had similar clinical and demographic characteristics. After 5 years of follow-up, we assessed the incidence of a composite endpoint (death, MI, emergency myocardial revascularization, acute CHF decompensation), quality of life (measured by the SF36 questionnaire), levels of anxiety and depression (measured by the HADS questionnaire), and levels of fatigue (measured by the MFI-20 questionnaire). By the end of the five-year observation period, data were available for 40 patients in the main group (11 patients were excluded from the study due to discontinuation of regular physical exercise) and 42 patients in the control group.Results. The incidence of the composite endpoint was 55.2% and 80.9% in main and control group, respectively (p = 0.038). Regular physical exercise over the five-year period was associated with a higher quality of life according to the SF36 questionnaire (64.5 [63.1; 67.8] vs. 49.2 [48.4; 49.8], p = 0.001), lower levels of anxiety (5.8 [5.1; 7.7] vs. 8.0 [6.8; 9.2], p = 0.042) and depression (2.9 [2.2; 4.2] vs. 10.7 [10.5; 12.3], p = 0.001) according to the HADS questionnaire, and lower levels of general fatigue according to the MFI-20 questionnaire (9.1 [8.5; 11.2] vs. 15.1 [14.5; 15.4], p = 0.019).Conclusion. Long-term regular physical exercise in patients with CHF and T2DM improves cardiovascular outcomes and psychological status of patients.