The aim of study was to estimate efficiency and safety of long-term exercise training (ЕТ) in HF patients and investigate their impact on clinical and functional status and skeletal muscles characteristics. 54 patients with left ventricular systolic dysfunction were investigated. EТ protocol based on use of serial six-minute walking tests for definition of optimum training walking rate during 12 months in 27 patients was applied. EТ have led to significant, compared to the control group, improvement of functional state, physical ability, left ventricular contractility, diuretic needs, increase of quadriceps force and endurance. The significant increase of knee flexor endurance was associated with more beneficial effect of EТ on physical ability of HF patients. During a year follow-up one patient of group ET and two patients of control group died. Application of EТ appeared safe and allowed to reduce essentially number of hospitalization due to HF deterioration in comparison with control group.