Document Detail

Beneficial effects of exercise training in heart failure patients with low cardiac output response to exercise - a comparison of two training models.
MedLine Citation:
PMID:  10447786     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Exercise capacity of patients with chronic heart failure (CHF) correlates poorly with estimates of cardiac function. Yet, it has been suggested that only patients without severely impaired cardiac output (CO) benefit from exercise training. Comparisons of different training models have not been made in the same study. AIMS: To evaluate whether the response to different training models diverges according to the cardiac output response to exercise in patients with chronic heart failure. METHODS: Sixteen CHF patients (63 +/- 11 years) with an ejection fraction of 30 +/- 11% underwent a baseline cardiopulmonary exercise test, right heart catheterization and leg muscle biopsy. Cardiac output (CO) response to exercise was defined as the ratio between CO increase and the increase in oxygen uptake (CO response index) during exercise. Patients were randomized into two training regimens, differing with regard to active muscle mass, i.e. whole body and one-legged exercise. RESULTS: Baseline exercise capacity expressed as W kg-1 correlated with the CO response index (r = 0.51, P < 0.05). Exercise capacity on the cycle ergometer increased in both groups but more in the one-legged than in the two-legged training group (P < 0.05). The improvement in exercise capacity did not correlate with base-line exercise capacity. It correlated with CO response index in the one-legged (r = 0.75, P < 0.01) but not in the two-legged training group. CO response index correlated negatively with the pulmonary capillary wedge pressure at peak exercise (r = - 0.60, P < 0.05). The increase in leg muscle citrate synthase activity after training correlated negatively with the baseline CO response index (r = - 0. 50, P < 0.05). CONCLUSIONS: The improvement of exercise capacity after one-legged training correlates with the CO increase in relation to the O2 uptake before training. In patients with low CO response, individualization of the exercise regimen is needed and the benefits of training a limited muscle mass at a time deserve further study.
A Gordon; R Tyni-Lenné; E Jansson; M Jensen-Urstad; L Kaijser
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of internal medicine     Volume:  246     ISSN:  0954-6820     ISO Abbreviation:  J. Intern. Med.     Publication Date:  1999 Aug 
Date Detail:
Created Date:  1999-09-02     Completed Date:  1999-09-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8904841     Medline TA:  J Intern Med     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  175-82     Citation Subset:  IM    
Department of Cardiology, Karolinska Institute at the Huddinge University Hospital, SE-141 86 Huddinge, Sweden.
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MeSH Terms
Exercise Test
Heart Failure / physiopathology*,  therapy*
Middle Aged
Stroke Volume*
Treatment Outcome

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