Chronic heart failure (CHF) is a complex disease process connected with cardiovascular system as well as other organs and
skeletal muscles. In connection with the above, cardiac rehabilitation, consisting of exercise training and diet supplementation,
aims at recovery of physical, social and psychic function and removing risk factors influencing the occurrence of circulatory
system diseases. Evidence has shown that exercise training in CHF patients, both aerobic and resistance, can increase peak
oxygen consumption and exercise capacity, improve NYHA (New York Heart Association) functional class, reduce mortality
and improve the quality of life. Evidence suggests that most improvement is due to the effects of training on the peripheral
circulation and skeletal muscle, rather than on the heart itself. Exercise training can improve skeletal muscle metabolism,
increase blood flow within the active skeletal muscles, increase capillary density, promote the synthesis and release of
nitric oxide, improve angiogenesis, and decrease oxidative stress. Physical effort reduces sympathetic arousal and increases
parasympathetic arousal, thus reducing cardiac dysrythmia and ischemia. Mitochondria start working harder, as the demand
for energy is higher and electron flow provides energy in the form of ATP. Studies have consistently demonstrated that
exercise training is safe and has no deleterious effect on central haemodynamics, left ventricular remodeling, systolic
or diastolic function, or myocardial metabolism. Taking several supplements that have documented roles in medical
therapy, including vitamins B, C and E, coenzyme Q10, alpha-lipoic acid, chromium, omega-3 polyunsaturated fatty acids,
L-carnitine, and quercetin, has beneficiary effect on many diseases, including CHF. In our experience, 19 patients with CHF
who undertook resistance (weight) training and food supplementation, returned to their normal activities after 4 months,
without any complaints.
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