professor of cardiology at Università Politecnica delle Marche School of Medicine and director of cardiac rehabilitation and prevention at Lancisi Heart Institute in Ancona， Italy. Dancing improves ability to function and quality of life among chronic heart failure patients and may be a good alternative to other aerobic exercises. It is a new choice of exercise training for patients with heart failure.

    This is good news， because if we want patients to take part in lifelong aerobic exercise at least three times a week， it should be something that"s fun and makes them want to continue. In a previous study， we found that dance-specifically， slow and fast waltz - was safe and improved functional capacity and quality of life for people who suffered from heart disease and previous heart attacks. We repeated the study in patients with chronic heart failure， and the results were identical.

    The amount of work during a session of dance is very similar to that of a session of traditional aerobic exercise. We studied 110 patients (89 men， average age 59) with stable chronic heart failure， meaning their left ventricular ejection fraction， which is the heart"s pumping ability， was less than 40 percent. A group of 44 patients were randomized to participate in supervised exercise training (cycling， treadmill) three times a week for eight weeks. Another group of 44 patients danced， alternating between slow (5 minutes) and fast (3 minutes) waltzes， lasting 21 minutes， three times a week for eight weeks. A third group (22 patients) had no exercise.

    Patients" heart rates were monitored during exercise and dancing sessions. At the start of the study and at eight weeks into it， all patients underwent cardiopulmonary exercise testing - an exercise stress test that analyzed ventilation and gas exchange to determine the effect of training and gauge functional ability. Participants also underwent imaging tests on their arteries. Patients then completed the Minnesota Heart Failure Living Questionnaire to rate their quality of life. Participants rated how heart failure affected their sleeping ability， participation in hobbies， housework， sexual activity， level of worry， depression and other aspects of daily life. The results indicate that dancing improves functional capacity and quality of life - particularly when it came to questions about emotions - among patients who underwent the dance protocol， while there was no improvement in these areas at eight weeks in the patients who did not exercise. Cardiopulmonary fitness increased at similar rates in those who did routine exercise training and in those who danced， with dancers experiencing slightly greater benefits. Oxygen consumption (peak V02) increased 16 percent among the exercisers and 18 percent among the dancers. Anaerobic threshold， the point above which muscles fatigue， increased 20 percent among exercisers and 21 percent among dancers. Ventilatory response (VE/VCO2) increased 14 percent among exercisers and 15 percent among dancers， while an index of cardiocirculatory fitness (VO2/W) increased 18 percent in exercisers and 19 percent among dancers. The dancing group"s arteries also had greater capacity to dilate (become more elastic) due to the effect of dancing on the inner part of the arterial wall (the endothelium) than non-exercisizers. The endothelium is stimulated by exercise to produce favorable substances， including nitric oxide， a gas that dilates and protects the arteries from atherosclerosis. Another improvement was that the cardiac fibers became more elastic. Quality of life was surprisingly more significantly improved in the dancing group versus the exercise group. Lower scores meant fewer problems interfering with a good quality of life， and among the dancers scores dropped from an average of 56 to 41. For the exercisers， scores dropped from an average of 58 to 48. 

    Ejection fraction didn"t significantly change in either the exercise or dancing group. No one had to withdraw from the study because of adverse events， indicating that dancing is safe. All these improvements have been demonstrated by standard exercise training based on stationary cycling or treadmill exercise. Thus， dancing is able to induce the same physiological benefits as standard aerobic exercise in patients with chronic heart failure. Studies should look at the heart-health effects of dancing on larger populations of people.