Effect of aerobic and resistance exercise on central hemodynamic responses in severe chronic heart failure

Abstract

Exercise is now considered an important component of management in chronic heart failure (CHF), but little is known about central hemodynamic changes that occur during different exercise modalities in these patients. Seventeen patients (ejection fraction 25 +/- 2%) undertook brachial artery and right heart catheterization and oxygen consumption assessment at rest, during submaximal and peak cycling (Cyc), and during submaximal upper and lower limb resistance exercise. Cardiac output (CO) increased relative to baseline during peak Cyc (P < 0.05) but did not change during submaximal Cyc or upper or lower limb exercise. Heart rate (HR) was lowest during upper limb exercise and progressively increased during lower limb exercise, submaximal Cyc, and peak Cyc, with significant differences between each of these (P < 0.01). Conversely, stroke volume (SV) decreased during submaximal Cyc and lower limb exercise and was lower during peak and submaximal Cyc and lower limb exercise than during upper limb exercise (P < 0.05). CHF patients are dependent on increases in HR to increase CO during exercise when SV may decline. Resistance exercise, performed at appropriate intensity, induces a similar hemodynamic burden to aerobic exercise in patients with CHF.

Resistance training for chronic heart failure patients on beta blocker medications

“…Periphery changes enable the muscle to uptake more oxygen from the blood contributing to an increased arterialvenous oxygen difference rather than increase in stroke volume and cardiac output [50]. It was demonstrated that stroke volume of severe chronic heart failure patients did not change or even decrease during exercise (both aerobic and resistance) [51]. Moreover, the maximal heart rate in the present chronic heart failure patients did not change after training.…”

A Meta-Analysis of the Effect of Exercise Training on Left Ventricular Remodeling in Heart Failure Patients

“…This may be because of the heightened systolic and diastolic pressure loading that occurs with strength training (36 -38). Moreover, the strength-training-mediated increase in LV wall stress, coupled with the impaired contractile and preload reserve, could explain why LV stroke volume and EF do not increase when HF patients perform this type of exercise (36,37).…”

The effect of resistance training on left ventricular function and structure of patients with chronic heart failure

“…Also, studies have suggested that during resistance exercise LV function of cardiac patients remains stable or is enhanced [33,36]. Cheetham et al [37] examined the effect of both isometric (40% of maximal voluntary contraction) and isotonic (submaximal and maximal cycling) exercises on cardiac output, SV and heart rate of patients with CHF including a sub-group of patients on beta-blocker medication. They reported that during isometric exercise and submaximal cycling, cardiac output did not change significantly in both modes of exercises.…”