Exploring Behavioral Interventions to Improve Heart Failure

Inclusion Criteria:

Ability to perform a 6-minute walk task, with or without use of a cane or walker (must use the same walking assistance device during each session), and walk under 500 meters during task.
Symptoms of chronic heart failure for at least 3 months.
Clinically stable- defined as not having been hospitalized for a 3 month period, on stable doses of neurohormonal blocking agents and diuretics for at least 3 months.
ACC/AHA stages B and C
Ability to perform light to moderate exercise (NYHA functional class II and III)
Presence of HF with an ejection fraction less than 40%, or diastolic dysfunction
Ability to give informed consent
At least18 years of age

Exclusion Criteria:

History of recent myocardial infarction (1 month)
Angina not adequately managed with nitrates.
Aortic or mitral stenosis
Coronary revascularization, mitral valve repair or any other cardiac surgery or implantation of a biventricular pacemaker within the past 6 months.
Severe COPD
Recent stroke or significant cerebral neurologic impairment.
Active Suicidality
Currently participating in an exercise program.
Currently taking mood stabilizers (e.g. lithium), benzodiazepines or antipsychotics.
Medications (steroids) and medical conditions affecting immune status not limited to Grave's Disease, Rheumatoid Arthritis, Hashimoto's Disease, Sjogren's Disease, Lupus, Multiple Sclerosis