A large international study is to evaluate the benefits of exercise for patients with heart failure, researchers report.

Although the benefits of exercise for most people are well known, "exercise training has not been definitely established to be safe for patients with heart failure", explain Dr David Whellan, from Jefferson Medical College in Philadelphia, Pennsylvania, USA, and colleagues in the American Heart Journal.

They add that, while a number of studies have suggested that mild exercise routines may improve the physical abilities of heart failure patients, "none of these trials enrolled a sufficient number of patients to properly evaluate the impact of exercise training on mortality or hospitalisation".

Dr Whellan and his team now hope to enrol around 3000 heart failure patients from 83 centres in Europe, the USA and Canada in one of the largest studies of exercise training on outcomes in heart failure patients ever performed.

All the participants will receive usual care consisting of heart failure medications and a self-management education program on topics such as medicines and their side effects, managing fluids and the importance of adhering to a low-salt diet. However, around half will also receive 36 supervised exercise-training sessions.

The patients will be monitored for up to 4 years and all hospitalisations and deaths recorded. The researchers will also compare changes in physical ability and quality of life between the two groups of participants.

"The patient population enrolled in this trial will be broadly representative of patients with heart failure, including large numbers of women, individuals of ethnic minority and individuals of low socioeconomic status," the researchers stress.

They conclude:" Exercise training represents an intervention that, if proven beneficial, would be accessible to most patients with heart failure because of its relatively low cost, high availability and ease of use."