OBJECTIVE: To test the hypothesis that combined aerobic and resistance training and non-invasive ventilatory support result in additional benefits compared with combined aerobic and resistance training alone in heart failure patients. DESIGN: A randomized, single-blind, controlled study. SETTING: Cardiac rehabilitation center. PARTICIPANTS: A total of 46 patients with New York Heart Association class II/III heart failure were randomly assigned to a 10-week program of combined aerobic and resistance training, plus non-invasive ventilatory support (n = 23) or combined aerobic and resistance training alone (n = 23). METHODS: Before and after intervention, results for the following were obtained: 6-minute walk test, forced vital capacity, forced expiratory volume at one second, maximal inspiratory muscle pressure, and maximal expiratory muscle pressure, with evaluation of dyspnea by the London Chest Activity of Daily Living scale, and quality of life with the Minnesota Living With Heart Failure questionnaire. RESULTS: Of the 46 included patients, 40 completed the protocol. The combined aerobic and resistance training plus non-invasive ventilatory support, as compared with combined aerobic and resistance training alone, resulted in significantly greater benefit for dyspnea (mean change 4.8 versus 1.3, p = 0.004), and quality of life (mean change 19.3 versus 6.8, p = 0.017). In both groups, the 6-minute walk test improved significantly (mean change: 45.7 versus 44.1, p = 0.924), but without a statistically significant difference. CONCLUSION: Non-invasive ventilatory support combined with combined aerobic and resistance training provides additional benefits for dyspnea and quality of life in moderate heart failure patients. TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT02384798. Registered 3 April 2015.

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