Circulation, Vol 79, 324-329, Copyright © 1989 by American Heart Association
MJ Sullivan, MB Higginbotham and FR Cobb
We have recently demonstrated that exercise training can induce important
hemodynamic and metabolic adaptations in patients with chronic heart
failure due to severe left ventricular dysfunction. This study examines the
accompanying changes in submaximal exercise performance and the ventilatory
response to exercise in these patients. Before and after 16-24 weeks of
exercise training, subjects underwent two symptom-limited bicycle exercise
tests, one with an incremental graded workload, and one with a constant
workload that represented 79 +/- 11% of the pretraining peak oxygen
consumption. Breath-by-breath expired gas analysis was performed
continuously during each test, and central hemodynamic, leg blood flow, and
blood lactate measurements were obtained during the incremental protocol.
The ventilatory anaerobic threshold was determined during the incremental
exercise study from coplotted breath-by-breath ventilatory data with
standard criteria by observers who were unaware of patient identity or
training status. As previously reported, exercise training increased peak
oxygen consumption by 23% from 16.8 +/- 3.8 to 20.6 +/- 4.7 ml/kg/min and
reduced blood lactate levels during submaximal exercise. The training-
induced decrease in lactate accumulation was accompanied by a decrease in
carbon dioxide production, respiratory exchange ratio, and ventilation
during submaximal exercise. The ventilatory anaerobic threshold was delayed
from 284 +/- 43 to 352 +/- 91 seconds of exercise (p = 0.02), and it
occurred at an increased oxygen consumption (10.1 +/- 1.2 vs. 12.1 +/- 2.6
ml/kg/min, p = 0.01). Exercise duration during the constant workload
protocol increased from 938 +/- 410 to 1,429 +/- 691 seconds (p less than
0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Exercise training in patients with chronic heart failure delays ventilatory anaerobic threshold and improves submaximal exercise performance
Department of Medicine, Duke University Medical Center, Durham, NC 27710.
This article has been cited by other articles:
 |
|
 |
|
  N. P. L. Rolim, A. Medeiros, K. T. Rosa, K. C. Mattos, M. C. Irigoyen, E. M. Krieger, J. E. Krieger, C. E. Negrao, and P. C. Brum Exercise training improves the net balance of cardiac Ca2+ handling protein expression in heart failure Physiol Genomics, May 11, 2007; 29(3): 246 - 252. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Rondon, M. S. Brasileiro-Santos, E. D. Moreira, M. U. P. B. Rondon, K. C. Mattos, M. A. Coelho, G. J. J. Silva, P. C. Brum, P. Fiorino, M. C. Irigoyen, et al. Exercise training improves aortic depressor nerve sensitivity in rats with ischemia-induced heart failure Am J Physiol Heart Circ Physiol, December 1, 2006; 291(6): H2801 - H2806. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Jelic and T. H. Le Jemtel Diagnostic Usefulness of B-Type Natriuretic Peptide and Functional Consequences of Muscle Alterations in COPD and Chronic Heart Failure. Chest, October 1, 2006; 130(4): 1220 - 1230. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. J. Nuhr, D. Pette, R. Berger, M. Quittan, R. Crevenna, M. Huelsman, G. F. Wiesinger, P. Moser, V. Fialka-Moser, and R. Pacher Beneficial effects of chronic low-frequency stimulation of thigh muscles in patients with advanced chronic heart failure Eur. Heart J., January 2, 2004; 25(2): 136 - 143. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Giannuzzi, P. L. Temporelli, U. Corra, and L. Tavazzi Antiremodeling Effect of Long-Term Exercise Training in Patients With Stable Chronic Heart Failure: Results of the Exercise in Left Ventricular Dysfunction and Chronic Heart Failure (ELVD-CHF) Trial Circulation, August 5, 2003; 108(5): 554 - 559. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. G. Hundley, D. W. Kitzman, T. M. Morgan, C. A. Hamilton, S. N. Darty, K. P. Stewart, D. M. Herrington, K. M. Link, and W. C. Little Cardiac cycle-dependent changes in aortic area and distensibility are reduced in older patients with isolated diastolic heart failure and correlate with exercise intolerance J. Am. Coll. Cardiol., September 1, 2001; 38(3): 796 - 802. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. T. Pu, M. T. Johnson, D. E. Forman, J. M. Hausdorff, R. Roubenoff, M. Foldvari, R. A. Fielding, and M. A. F. Singh Randomized trial of progressive resistance training to counteract the myopathy of chronic heart failure J Appl Physiol, June 1, 2001; 90(6): 2341 - 2350. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Coirault, A. Hagege, D. Chemla, M.-D. Fratacci, C. Guerot, and Y. Lecarpentier Angiotensin-Converting Enzyme Inhibitor Therapy Improves Respiratory Muscle Strength in Patients With Heart Failure Chest, June 1, 2001; 119(6): 1755 - 1760. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Recommendations for exercise training in chronic heart failure patients Eur. Heart J., January 2, 2001; 22(2): 125 - 135. [PDF]
|
|
|
|
 |
|
 N. L. Jones and K. J. Killian Exercise Limitation in Health and Disease N. Engl. J. Med., August 31, 2000; 343(9): 632 - 641. [Full Text] [PDF]
|
|
|
|
|
|
H. M. Krumholz, D. W. Baker, C. M. Ashton, S. B. Dunbar, G. C. Friesinger, E. P. Havranek, M. A. Hlatky, M. Konstam, D. L. Ordin, I. L. Pina, et al. Evaluating Quality of Care for Patients With Heart Failure Circulation, March 28, 2000; 101 (12): e122 - e140. [Full Text] [PDF]
|
|
|
|
|
|
R.P. Wielenga, I.A. Huisveld, E. Bol, P.H.J.M. Dunselman, R.A.M. Erdman, M.R.P. Baselier, and W.L. Mosterd Safety and effects of physical training in chronic heart failure. Results of the Chronic Heart Failure and Graded Exercise study (CHANGE): (CHANGE) Eur. Heart J., June 2, 1999; 20(12): 872 - 879. [Abstract] [PDF]
|
|
|
|
|
|
A. J. S. Coats Exercise Training for Heart Failure : Coming of Age Circulation, March 9, 1999; 99(9): 1138 - 1140. [Full Text] [PDF]
|
|
|
|
|
|
D. Ramos-Barbon, D. Fitchett, W. J. Gibbons, D. A. Latter, and R. D. Levy Maximal Exercise Testing for the Selection of Heart Transplantation Candidates: Limitation of Peak Oxygen Consumption Chest, February 1, 1999; 115(2): 410 - 417. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Vescovo, L. Dalla Libera, F. Serafini, C. Leprotti, L. Facchin, M. Volterrani, C. Ceconi, and G. B. Ambrosio Improved Exercise Tolerance After Losartan and Enalapril in Heart Failure : Correlation With Changes in Skeletal Muscle Myosin Heavy Chain Composition Circulation, October 27, 1998; 98(17): 1742 - 1749. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. R. Chin, E. N. Olson, J. A. Richardson, Q. Yang, C. Humphries, J. M. Shelton, H. Wu, W. Zhu, R. Bassel-Duby, and R. S. Williams A calcineurin-dependent transcriptional pathway controls skeletal muscle fiber type Genes & Dev., August 15, 1998; 12(16): 2499 - 2509. [Abstract] [Full Text]
|
|
|
|
 |
|
 R. P Wielenga, A. J S Coats, W. L Mosterd, and I. A Huisveld The role of exercise training in chronic heart failure Heart, November 1, 1997; 78(5): 431 - 436. [Full Text] [PDF]
|
|
|
|
|
|
P. Giannuzzi, P. L. Temporelli, U. Corra, M. Gattone, A. Giordano, L. Tavazzi, and f. t. E. S. Group Attenuation of Unfavorable Remodeling by Exercise Training in Postinfarction Patients With Left Ventricular Dysfunction : Results of the Exercise in Left Ventricular Dysfunction (ELVD) Trial* Circulation, September 16, 1997; 96(6): 1790 - 1797. [Abstract] [Full Text]
|
|
|
|
|
|
C. C. Lang, D. B. Chomsky, G. Rayos, T. K. Yeoh, and J. R. Wilson Skeletal muscle mass and exercise performance in stable ambulatory patients with heart failure J Appl Physiol, January 1, 1997; 82(1): 257 - 261. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. B. Chomsky, C. C. Lang, G. H. Rayos, Y. Shyr, T.-K. Yeoh, R. N. Pierson III, S. F. Davis, and J. R. Wilson Hemodynamic Exercise Testing: A Valuable Tool in the Selection of Cardiac Transplantation Candidates Circulation, December 15, 1996; 94(12): 3176 - 3183. [Abstract] [Full Text]
|
|
|
|
|
|
J. R. Wilson, J. Groves, and G. Rayos Circulatory Status and Response to Cardiac Rehabilitation in Patients With Heart Failure Circulation, October 1, 1996; 94(7): 1567 - 1572. [Abstract] [Full Text]
|
|
|
|
|
|
G. F. Fletcher, G. Balady, S. N. Blair, J. Blumenthal, C. Caspersen, B. Chaitman, S. Epstein, E. S. S. Froelicher, V. F. Froelicher, I. L. Pina, et al. Statement on Exercise: Benefits and Recommendations for Physical Activity Programs for All Americans: A Statement for Health Professionals by the Committee on Exercise and Cardiac Rehabilitation of the Council on Clinical Cardiology, American Heart Association Circulation, August 15, 1996; 94(4): 857 - 862. [Full Text]
|
|
|
|
|
|
P. B.M. Clarkson, N. M. Wheeldon, R. J. MacFadyen, S. D. Pringle, and T. M. MacDonald Effects of Brain Natriuretic Peptide on Exercise Hemodynamics and Neurohormones in Isolated Diastolic Heart Failure Circulation, June 1, 1996; 93(11): 2037 - 2042. [Abstract] [Full Text]
|
|
|
|
|
|
M. Piepoli, A. L. Clark, M. Volterrani, S. Adamopoulos, P. Sleight, and A. J.S. Coats Contribution of Muscle Afferents to the Hemodynamic, Autonomic, and Ventilatory Responses to Exercise in Patients With Chronic Heart Failure : Effects of Physical Training Circulation, March 1, 1996; 93(5): 940 - 952. [Abstract] [Full Text]
|
|
|
|
|
|
COMMITTEE MEMBERS, J. F. WILLIAMS Jr, M. R. BRISTOW, M. B. FOWLER, G. S. FRANCIS, A. GARSON Jr, B. J. GERSH, D. F. HAMMER, M. A. HLATKY, C. V. LEIER, et al. Guidelines for the Evaluation and Management of Heart Failure : Report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (Committee on Evaluation and Management of Heart Failure) Circulation, November 1, 1995; 92(9): 2764 - 2784. [Full Text]
|
|
|
|
|
|
J. R. Wilson, G. Rayos, T. K. Yeoh, P. Gothard, and K. Bak Dissociation Between Exertional Symptoms and Circulatory Function in Patients With Heart Failure Circulation, July 1, 1995; 92(1): 47 - 53. [Abstract] [Full Text]
|
|
|
|
|
|
R. Belardinelli, D. Georgiou, G. Cianci, N. Berman, L. Ginzton, and A. Purcaro Exercise Training Improves Left Ventricular Diastolic Filling in Patients With Dilated Cardiomyopathy : Clinical and Prognostic Implications Circulation, June 1, 1995; 91(11): 2775 - 2784. [Abstract] [Full Text]
|
|
|
|
|
|
D. M. Mancini, D. Henson, J. L. Manca, L. Donchez, and S. Levine Benefit of Selective Respiratory Muscle Training on Exercise Capacity in Patients With Chronic Congestive Heart Failure Circulation, January 15, 1995; 91(2): 320 - 329. [Abstract] [Full Text]
|
|
|
|
|
|
J. R. Wilson Exercise Intolerance in Heart Failure : Importance of Skeletal Muscle Circulation, January 15, 1995; 91(2): 559 - 561. [Full Text]
|
|
|
|
 |
|
 J. Myers and V. F. Froelicher Hemodynamic Determinants of Exercise Capacity in Chronic Heart Failure Ann Intern Med, September 1, 1991; 115(5): 377 - 386. [Abstract] [PDF]
|
|