Considerations Related to Disability and Exercise in Elderly Women with Congestive Heart Failure

Congestive heart failure is one of the most common diagnoses in older women. This article reviews physiologic and pathophysiologic factors that contribute to disability in older women with normal left ejection fraction congestive heart failure; the possibility that aerobic exercise training may be an effective means to reduce the disability experienced by these women is examined. Most literature has dealt with low-output ejection fraction congestive heart failure. Comparisons between low-output ejection fraction congestive heart failure and normal left ejection fraction congestive heart failure can help to clarify beneficial interventions. A physiologic model is proposed that includes peripheral and cardiac factors caused by heart disease, and factors caused by aging, that may account for increasing the disabling consequences and reducing exercise tolerance of older women with normal left ejection fraction congestive heart failure. The potential impact of exercise training on these factors is discussed. Directions for practice and further research are included.