Clinical Investigation
Effects of Interval Cycle Training With or Without Strength Training on Vascular Reactivity in Heart Failure Patients

This study has been presented at the 4th EuroPRevent Annual Congress 2009.
https://doi.org/10.1016/j.cardfail.2011.02.009Get rights and content

Abstract

Background

Exercise training confers beneficial effects on vascular reactivity in patients with chronic heart failure (CHF). This randomized study compares the effects of interval cycle training combined with strength training versus interval training alone on vascular reactivity in CHF patients.

Methods

Twenty-eight consecutive stable CHF patients (23 males, 53 ± 10 years, 28.4 ± 4.1 kg/m2, left ventricular ejection fraction of 37 ± 12%) were randomly assigned to 3 times’ weekly training sessions for 3 months, consisting of a) 40 minutes of interval cycle training (n = 14), versus b) 20 minutes of similar interval training plus 20 minutes of strength training of the quadriceps, hamstrings, muscles of the shoulder and biceps brachialis (n = 14). The work/recovery ratio of each session was 30/60 seconds. The intensity of interval training was set at 50% of the peak workload achieved at the steep ramp test (consisted of a 25-Watt increase on a cycle ergometer every 10 seconds until exhaustion). All patients underwent maximal, symptom-limited cardiopulmonary exercise testing and ultrasound evaluation of vascular reactivity by flow-mediated vasodilation (FMD) before and after the program.

Results

A significant improvement in FMD was observed in the combined training group (P = 0.002), in contrast to the interval training alone group (P = NS); the improvement was significantly greater in the combined training than in the interval training alone group (P < .05). Peak oxygen uptake increased significantly and similarly in both groups, in the interval training group (P = .03), and in the combined training group (P = .006). No significant correlation was found between FMD improvement and cardiopulmonary exercise parameters.

Conclusions

A combined high-intensity, interval cycle exercise with strength training induces a greater beneficial effect on vascular reactivity rather than interval exercise training alone in CHF patients.

Section snippets

Patient Study Population

The study population consisted of 41 consecutive patients with stable systolic heart failure and New York Heart Association (NYHA) functional Class ≤III and optimal medical treatment including β-blockers, angiotensin-converting enzyme inhibitors diuretics, spironolactone, amiodarone, and digoxin. All patients included at the study had a diagnosis of systolic heart failure based on symptoms/signs typical of heart failure and left ventricular ejection fraction less than 45% at stable optimal

Results

Forty-one CHF patients were consecutively considered eligible for inclusion in the study and were initially recruited. Twenty-one patients were finally randomized in the interval cycle training group and 20 patients at the combined group. Five patients from the interval cycle training group and 2 patients from the combined group did not complete the program (withdrew). One patient from each group was excluded because of diabetes mellitus. Four patients (1 from the aerobic group) were excluded

Discussion

This study has shown that exercise training improves vascular reactivity in CHF patients after a 3-month rehabilitation program. Specifically, high-intensity interval cycle training combined with strength training induces significant improvement in vascular reactivity in CHF patients compared with interval training alone. Both exercise groups increased exercise capacity in CHF patients. To our knowledge, this is the first study to evaluate the combined interval and strength training effects on

Conclusion

Exercise training improves vascular reactivity in CHF patients during a 3-month rehabilitation program. A combined program consisting of high-intensity interval cycle exercise and strength training appeared more beneficial and conferred greater improvements on vascular reactivity than interval training alone. These findings suggest that strength training should be added as a complementary program to interval training in maximizing exercise beneficial effects.

Disclosures

None.

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    Partially funded by a grant from the Special Account for Research Grants of the National Kapodistrian University of Athens, Greece and by the Thorax Foundation.

    See page 590 for disclosure information.

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