Document Detail


Effect of endurance training on the determinants of peak exercise oxygen consumption in elderly patients with stable compensated heart failure and preserved ejection fraction.
MedLine Citation:
PMID:  22766338     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The purpose of this study was to evaluate the mechanisms for improved exercise capacity after endurance exercise training (ET) in elderly patients with heart failure and preserved ejection fraction (HFPEF).
BACKGROUND: Exercise intolerance, measured objectively by reduced peak oxygen consumption (VO(2)), is the primary chronic symptom in HFPEF and is improved by ET. However, the mechanisms are unknown.
METHODS: Forty stable, compensated HFPEF outpatients (mean age 69 ± 6 years) were examined at baseline and after 4 months of ET (n = 22) or attention control (n = 18). The VO(2) and its determinants were assessed during rest and peak upright cycle exercise.
RESULTS: After ET, peak VO(2) in those patients was higher than in control patients (16.3 ± 2.6 ml/kg/min vs. 13.1 ± 3.4 ml/kg/min; p = 0.002). That was associated with higher peak heart rate (139 ± 16 beats/min vs. 131 ± 20 beats/min; p = 0.03), but no difference in peak end-diastolic volume (77 ± 18 ml vs. 77 ± 17 ml; p = 0.51), stroke volume (48 ± 9 ml vs. 46 ± 9 ml; p = 0.83), or cardiac output (6.6 ± 1.3 l/min vs. 5.9 ± 1.5 l/min; p = 0.32). However, estimated peak arterial-venous oxygen difference was significantly higher in ET patients (19.8 ± 4.0 ml/dl vs. 17.3 ± 3.7 ml/dl; p = 0.03). The effect of ET on cardiac output was responsible for only 16% of the improvement in peak VO(2).
CONCLUSIONS: In elderly stable compensated HFPEF patients, peak arterial-venous oxygen difference was higher after ET and was the primary contributor to improved peak VO(2). This finding suggests that peripheral mechanisms (improved microvascular and/or skeletal muscle function) contribute to the improved exercise capacity after ET in HFPEF. (Prospective Aerobic Reconditioning Intervention Study [PARIS]; NCT01113840).
Authors:
Mark J Haykowsky; Peter H Brubaker; Kathryn P Stewart; Timothy M Morgan; Joel Eggebeen; Dalane W Kitzman
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  60     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-07-06     Completed Date:  2012-10-25     Revised Date:  2013-07-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  120-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Affiliation:
Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada.
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MeSH Terms
Descriptor/Qualifier:
Aged
Exercise Tolerance / physiology*
Female
Heart Failure / physiopathology*
Hemodynamics
Humans
Male
Middle Aged
Muscle, Skeletal / physiology*
Oxygen Consumption / physiology*
Stroke Volume
Ventricular Function, Left / physiology
Grant Support
ID/Acronym/Agency:
M01 RR007122/RR/NCRR NIH HHS; MO1RR07122/RR/NCRR NIH HHS; P30 AG021332/AG/NIA NIH HHS; P30AG21332/AG/NIA NIH HHS; R01 AG012257/AG/NIA NIH HHS; R01AG12257/AG/NIA NIH HHS; R37 AG018915/AG/NIA NIH HHS; R37 AG18915/AG/NIA NIH HHS
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2012 Jul 10;60(2):129-31   [PMID:  22766339 ]

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