Comparison of hemodynamic responses to cycling and resistance exercise in congestive heart failure secondary to ischemic cardiomyopathy

McKelvie, Robert S.; McCartney, Neil; Tomlinson, Charles W.; Bauer, Robert O.; MacDougall, J. D.

doi:10.1016/s0002-9149(99)80277-x

Cited by 75 publications

(44 citation statements)

References 18 publications

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“…Conversely, RT causes a marked rise in both systolic and diastolic BP and consequently mean blood pressures, with less of a rise in heart rate compared with aerobic exercise. 101 Thus, RT imposes primarily a pressure load on the heart. Because of the considerably lower response of heart rate during RT, this mode of exercise generally results in a lower rate-pressure product compared with aerobic exercise.…”

Section: Screening and Precautionsmentioning

confidence: 99%

Resistance Exercise Training

Braith

Stewart²

2006

Circulation

404

119

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T he metabolic effects of reduced muscle mass, engendered by normal aging or decreased physical activity, lead to a high prevalence of obesity, insulin resistance, type 2 diabetes, dyslipidemia, and hypertension. [1][2][3][4] These risk factors are associated with abnormalities in cardiovascular structure and function such as arterial stiffness and impaired endothelial function. Skeletal muscle is the primary metabolic "sink" for glucose and triglyceride disposal and is an important determinant of resting metabolic rate. Accordingly, it has been hypothesized that resistance exercise training (RT) and subsequent increases in muscle mass may reduce multiple cardiovascular (CV) disease risk factors. [5][6][7][8] The inclusion of RT as part of an exercise program for promoting health and preventing disease has been endorsed by the American Heart Association, 9 American College of Sports Medicine, 10 and the American Diabetes Association 11 as an integral part of an overall health and fitness program. Cross-sectional studies have shown that muscular strength is inversely associated with all-cause mortality 12 and the prevalence of metabolic syndrome, 13,14 independent of cardiorespiratory fitness levels. To date, however, the evidence that RT reduces CV risk factors remains equivocal.This review will critically evaluate whether RT modifies CV risk factors and improves characteristics of CV structure and function. The topics will be limited to the effects of RT on major and independent risk factors for CV disease including diabetes mellitus, hypertension, dyslipidemia, and advancing age. 4 The quantitative relation between these risk factors and CV events has been elucidated by the Framingham Heart Study 4 and other studies. The topics will also include 2 predisposing risk factors-obesity and physical inactivity-that are designated as major risk factors by the American Heart Association. 1,2,4 To the extent possible, this review will examine the separate and independent effects of RT in studies that did not include a concomitant aerobic exercise component. However, in those instances where the data from RT studies are equivocal, studies that combined RT and aerobic exercise will be acknowledged to help the clinician formulate recommendations for their patients. Additionally, the review will focus mainly on primary prevention, for example, risk reduction in persons without established CV disease. Many low-to moderate-risk patients with established CV disease should be encouraged to incorporate RT into their physical conditioning program, especially those who rely on their upper extremities for work or recreational pursuits. However, the safety and effectiveness of RT in other populations of CV patients (eg, women, older patients with low aerobic fitness, patients with severe left ventricular dysfunction) have not been well studied. Accordingly, these patient subsets may require more careful evaluation and initial monitoring, and RT guidelines and recommendations must be modified accordingly. Moreover, there is only a l...

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Section: Screening and Precautionsmentioning

confidence: 99%

Resistance Exercise Training

Braith

Stewart²

2006

Circulation

404

119

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“…Regular resistance training improves both muscle strength and endurance, without adverse effects on hemodynamics [70] or left ventricular characteristics [23, 71,72]. Increases in both muscle strength and endurance with resistance training often exceed 20-30% [20, 69, 71-73]; however, whether or not this mode of training improves aerobic exercise capacity in these patients remains controversial [23, 69,71].…”

Section: Skeletal Muscle Adaptationsmentioning

confidence: 99%

Role and benefits of exercise in the management of patients with heart failure

et al. 2010

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Initial research established the feasibility of exercise training in patients with heart failure, as well as associated physiological benefits. This review summarizes the findings from over two dozen single-site studies that address the effect of exercise training on exercise capacity and cardiovascular and peripheral function. In addition, it incorporates the results from two meta-analyses and a recently completed multi-center trial, all of which studied the effects of exercise training on clinical outcomes. The major conclusions from these studies are that exercise training is safe; improves health status and exercise capacity; helps attenuate much of the abnormal pathophysiology that develops with heart failure; and yields a modest reduction in clinical events. The magnitude of the clinical benefits appears related to the volume of exercise completed. Future research is needed to identify which patient subgroups might benefit the most from exercise training, the optimal exercise dose or load needed to lessen disease-related symptoms and maximize clinical benefit, and the effects of exercise training in patients with heart failure and preserved left ventricular systolic function.

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“…[40]. Dies ging mit einer niedrigeren Herzfrequenz, aber höherem diastolischen Blutdruck einher ohne Unterschied im linksventrikulären Volumen oder der Auswurffraktion.…”

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“…Daraus lässt sich ein niedrigerer myokardialer Sauerstoffbedarf bei Krafttraining ableiten. Eine Verbesserung der Perfusion durch die höheren diastolischen Drucke bei gleichzeitig geringerer Herzfrequenz wäre denkbar [40]. Auch bei KHK-Patienten konnte trotz höhe-rem systolischem und diastolischem Blutdruck, jedoch niedrigerer Herzfrequenz bei gleichem Druck-FrequenzProdukt eine geringere ST-Strecken-Senkung im EKG während der einer kombinierten Kraft-Ausdauerbelastung im Vergleich zur Ausdauerbelastung nachgewiesen werden [41].…”

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“…Es handelt sich hierbei um einen kurzfristigen Frequenzabfall nach dem Pressen mit ev. Auftreten einer Synkope[2].Trotz der potentiell gefährlichen akuten Auswirkungen auf den Blutdruck zeigen entsprechende Trainingsstudien an kardialen Patienten keine zusätzliche Erhöhung des kardialen Risikos durch Krafttraining bei Patienten nach Myokardinfarkt, chronischer Herzinsuffizienz oder nach Herztransplantation[36,39,40,[47][48][49][50][51][52][53][54].…”

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Bedeutung des Krafttrainings zur Prävention und Rehabilitation internistischer Erkrankungen

Wonisch

Marko²,

Niebauer³

et al. 2012

Wien Klin Wochenschr

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Physical training is part of the recommendations for prevention and rehabilitation of cardiovascular and metabolic diseases. The main focus was on endurance training for a long time. However, a positive effect of strength training has also been found for patients with with a wide spectrum of diseases. Beside the improvement of muscle strength similar positive effects as with endurance training have been documented. Moreover, improvements of quality of life and mobility have been found, mainly for older patients. Resistance training is safe and can be recommended to a wide range of patients including those with reduced left ventricular function.

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Comparison of hemodynamic responses to cycling and resistance exercise in congestive heart failure secondary to ischemic cardiomyopathy

Cited by 75 publications

References 18 publications

Resistance Exercise Training

Resistance Exercise Training

Role and benefits of exercise in the management of patients with heart failure

Bedeutung des Krafttrainings zur Prävention und Rehabilitation internistischer Erkrankungen

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