Document Detail


Resistance training improves cardiac output, exercise capacity and tolerance to positive airway pressure in Fontan physiology.
MedLine Citation:
PMID:  23154055     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Subjects with Fontan-type circulation have no sub-pulmonary ventricle and thus depend exquisitely on the respiratory bellows and peripheral muscle pump for cardiac filling. We hypothesised that resistance training to augment the peripheral muscle pump might improve cardiac filling, reduce inspiratory-dependence of IVC return to the heart and thus improve exercise capacity and cardiac output on constant positive airway pressure (CPAP). METHODS: Eleven Fontan subjects (32+/-2years, mean+/-SEM) had cardiac magnetic resonance imaging (MRI) and exercise testing (CPET); six underwent 20weeks of high-intensity resistance training; others were non-exercising controls. After training, CPET was repeated. Four trainers had MRI with real-time flow measurement at rest, exercise and on CPAP in the trained state and following a 12-month detrain. RESULTS: In the trained state, muscle strength increased by 43% (p=0.002), as did total muscle mass (by 1.94kg, p=0.003) and peak VO(2) (by 183ml/min, p=0.02). After detraining, calf muscle mass and peak workload had fallen significantly (p<0.03 for both) as did peak VO(2) (2.72 vs. 2.18l/min, p<0.001) and oxygen pulse, a surrogate for SV (16% lower, p=0.005). Furthermore after detraining, SV on MRI decreased at rest (by 11ml, p=0.01) and during moderate-intensity exercise (by 16ml, p=0.04); inspiratory-dependent IVC blood return during exercise was 40% higher (p=0.02). On CPAP, cardiac output was lower in the detrained state (101 vs. 77ml/s, p=0.03). CONCLUSIONS: Resistance muscle training improves muscle mass, strength and is associated with improved cardiac filling, stroke volume, exercise capacity and cardiac output on CPAP, in adults with Fontan-type circulation.
Authors:
Rachael L Cordina; Shamus O'Meagher; Alia Karmali; Caroline L Rae; Carsten Liess; Graham J Kemp; Raj Puranik; Nalin Singh; David S Celermajer
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-12
Journal Detail:
Title:  International journal of cardiology     Volume:  -     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia; Department of Cardiology, Sydney Medical School, Sydney, Australia.
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