Short-term walking physical training and changes in body hydration status, B-type natriuretic peptide and C-reactive protein levels in compensated congestive heart failure.

BACKGROUND: Congestive heart failure (CHF) is associated with decreased exercise tolerance, alterations in body fluid balance and activation of neurohumoral and inflammatory pathways. Physical training, despite the contraindications of the past, is recommended for its beneficial effects on exercise capacity and quality of life. We investigate the effects of a short-term (ten weeks) walking physical training program (PT) on body hydration state (HS), B-type natriuretic peptide (BNP) and C-reactive protein (CRP) levels. METHODS AND RESULTS: 22 patients with CHF (mean age 62.7+/-4.8 years, 15 men, mean ejection fraction 38.9+/-3.6%, NYHA class II-III), were enrolled. Eleven patients were randomly assigned to PT for 30 min for 5 days/week. Baseline hydration status was detected by using bioelectrical impedance analysis (BIA). After 10 weeks, PT resulted in a significant reduction of BNP (p<0.05) and CRP plasma level (p<.05) and in a significant improvement of hydration status (p<.05), of NYHA class, Minnesota living with heart failure questionnaire (p<.05) and 6 min walk test (p<.0002) only in PT group. A significant correlation was found between BIA parameters, BNP and NYHA class. CONCLUSION: A walking PT program is safe and effective to modulate positively neurohumoral and inflammatory markers and to maintain and improve hydration status in patients with CHF. BIA is useful to assess the body fluid balance in these patients.