Prospective Aerobic Reconditioning Intervention Study (PARIS)

Inclusion Criteria:

• Age greater than or equal to 60 years of age
• Symptoms of congestive heart failure
• Able to understand and give informed consent

Exclusion Criteria:

• Age <60 years
• Does not have CHF
• Significant change in cardiac medication <3 weeks
• Myocardial infarction <3 weeks
• CABG surgery <3 months
• Angina pectoris not controlled during daily activity by pharmacological therapy or at <4 METS activity
• Sustained hypertension with systolic> 190 and diastolic> 110 on medications
• Valvular heart disease as the primary etiology of CHF
• Significant aortic stenosis
• Stroke of <3 months or with any physical restriction impairment that would prevent participation in exercise programs
• Chronic obstructive pulmonary disease on therapy that limits exercise duration
• Uncontrolled diabetes mellitus
• Active treatment for cancer or other noncardiovascular conditions with life expectancy less than three years
• Anemia "10 gms Hb)
• Renal insufficiency (cr >2.5 mg/dl)
• Psychiatric disease - uncontrolled major psychoses, depressions, dementia, or personality disorder
• Dementia - MMSE ~24 "22 for ~8th grade education)
• Lack of an acoustic window sufficient to allow definition of endocardial borders on the screening echocardiogram.
• Plans to leave area or be admitted to a nursing home within 2 years.
• Inability to walk at least 420 feet in 6 minutes without a cane or other assistive device.
• Inability to exercise at or near home.
• At the discretion of the clinical staff, it is believed that the participant cannot or will not complete the protocol because of frailty, illness, or other reason.
• Participation in a regular exercise regimen more than one time per week for at least twenty minutes per session; including but not limited to walking, swimming, weight lifting, golfing, or taking an exercise class.
• Inability to ambulate without cane or other assistive device during biomechanics testing or treadmill.
• Inability to attend at least fourteen weeks of the facility-based intervention