Published Online
on May 28, 2008

A more recent version of this article appeared on July 1, 2008

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Original Article

Waltz-Dancing in Patients With Chronic Heart Failure: A New Form of Exercise Training

Romualdo Belardinelli¹; Francesca Lacalaprice; Chiara Ventrella; Loretta Volpe and Ernesto Faccenda

Lancisi Heart Institute

¹ E-mail: r.belardinelli{at}fastnet.it

Background—There is evidence that aerobic exercise improves functional capacity in NYHA class II and III chronic heart failure patients (CHF). However, it is unknown whether dancing may be safe and able to improve functional capacity in CHF patients.

Methods and Results—We prospectively studied 130 patients with stable CHF (107 males, mean age 59±11 years) in NYHA class II and III and LV ejection fraction <40%. Patients were randomized to supervised aerobic exercise training at 70% of peak VO2 3 times a week for 8 weeks (group E, n=44), or to a dance protocol of alternate slow (5 min) and fast (3 min) waltz lasting 21 minutes (group D, n=44). A group was not exercised and served as control (group C, n=42). On study entry and at 8 weeks all patients underwent a cardiopulmonary exercise testing on a cycle ergometer until volitional fatigue, 2D-echo with Doppler, and endothelium-dependent dilation (EDD) of the brachial artery. Results: heart rate was 111±15 beats/min during exercise training, and 113±19 beats/min during dancing (P=0.59). Peak VO2, anaerobic threshold, VE/VCO2 slope, and VO2/W slope were all similarly improved in both E and D groups (+16% and 18%, 20% and 21%, 14% and 15%, 18% and 19%, respectively, P NS for all comparisons, P<0.001 vs controls). Endothelium-dependent relaxation was also similarly improved (group E, from 2.6±1.3% to 5.2±1.5%, P<0.001 vs control; group D, from 2.2±1.4% to 5.0±1.5%, P<0.001 vs control for both E and D). The change in peak VO2 in E and D groups was correlated with changes in E/A ratio (r=-0.58, P<0.001 and EDD (r=0.64,P<0.001). Untoward events were rare in both E and D groups.

Conclusions—In stable CHF patients waltz-dancing is safe and able to improve functional capacity and EDD similar to traditional aerobic exercise training. Waltz-dancing may be considered in clinical practice in combination with aerobic exercise training or as an alternative to it.

Key Words: chronic heart failure • dancing • exercise training