Inclusion Criteria:  Adults 40-60 years old who are sedentary. Left ventricular ejection fraction of less than 45% evaluated by echocardiogram Functional class II and III (New York Heart Association) FEV1 less than 80%, predicted and/or FEV1/ forced vital capacity (FVC) ratio of more than 70% predicted, and clinical stability. Ex-smokers of more than 5 years.  Exclusion Criteria:  Myocardial infarction Complex arrhythmias Uncontrolled hypertension Angina pectoris. Cognitive disorders Recent any trauma. Chronic respiratory disease. Unstable angina Recent viral infections (6 months before the study