Heart patients pump out data
Donna Fry had a scary moment one night in 1993 while toting laundry up the stairs.
“I had to stop halfway up the steps; I couldn’t breathe,” Fry says. “My husband said I had to go to the emergency room right then.”
Fry, a 67-year-old Sellersburg, Ind., resident, learned while being treated that one of her arteries was more than 90 percent blocked. She underwent a heart catheter procedure at River Cities Cardiology Cardiac Rehabilitation Clinic in Jeffersonville, Ind., and then had the arterial blockage cleared with an angioplasty performed at Jewish Hospital in Louisville.
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U of L’s Ann Swank and colleagues want to see if vigorous exercise can prolong life and shorten hospital stays for heart patients.
With her history of heart problems, Fry was the perfect candidate to participate in a major new national study to assess the effects of regular exercise on patients with congestive heart failure.
The Exercise Physiology Lab in U of L’s College of Education and Human Development is one of 60 sites in the United States and Canada participating in the $37-million, 3,000-patient trial, known as the Heart Failure and a Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION). The five-year study, sponsored by the National Heart, Lung and Blood Institute of the National Institutes of Health, is the first large-scale prospective trial to determine whether exercise helps heart failure patients live longer and reduces their hospital stays.
The results could help many of the 4.8 million Americans who suffer from congestive heart failure. More than a half million new cases are reported yearly. Once diagnosed, about 50 percent die within five years.
U of L’s exercise physiology lab conducts the study in partnership with the River Cities clinic. So far, they’ve worked with 42 patients and plan to have 68 patients within the next 18 months.
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Heart patient Donna Fry.
Ann Swank, professor of exercise physiology, and Dr. D. Marty Denny, project medical director, are study co-investigators. They work with study coordinator John Manire (a U of L alumnus) and rehabilitation director Amy Allard to administer a structured exercise regimen tailored to each patient’s medical condition and physical ability.
“I’m 67 and overweight, and I don’t exercise like I should,” Fry says. “The doctors wanted to see if exercise would help people like me.”
For the first three months, patients exercise three times weekly under clinic supervision on a treadmill or stationary bicycle. Patients then receive a treadmill or stationary bicycle to continue their customized workout at home for three years.
The U of L research team monitors the patients’ health and ensures that they continue to exercise. Researchers then compare fitness levels of the exercise group to a control group of heart failure patients who are getting the latest standard of care for their condition, but without the structured exercise program. The study team hopes to glean if exercise reduces the amount and duration of hospitalization and mortality from the disease.
After her treadmill workouts, Fry is checked regularly for changes in blood pressure and notes her own heart rate, feelings and perception of effort in a log that will be studied by the researchers.
Swank says she already has noticed changes in some subjects in both the HF-ACTION study and a related NIH-sponsored study on strength training in heart patients.
“We have a group of people, maybe 20 to 25 percent of whom had never done any exercise and are now doing a pretty intense, aggressive regimen. We have people in their 70s and 80s doing some rigorous exercise.
“I think just seeing some of the exercises these patients do dispels the myth that they can’t do them.”