Abstract 3958: Combined Endurance-Resistance Training versus Endurance Training in Patients with Chronic Heart Failure
Introduction: Despite advantages and observed clinical benefits, official recommendations still caution against resistance exercise training in patients with Chronic Heart Failure (CHF).The aim of this study was to compare the effects of combined endurance-resistance training (CT) with endurance training (ET) only on exercise capacity (EC), ventilatory parameters (VP) and skeletal muscle strength (SMS) in patients with CHF.
Methods: 86 patients with stable CHF were randomized into a CT-group (n=42, 58.4y ± 10.9, left ventricular ejection fraction (LVEF) 27.1% ± 7.4, PeakVO2 18.1 ml/kg/min ± 4.3) or an ET-group (n=44, 58.8y ± 10.7, LVEF 24% ± 9.1, PeakVO2 21.1 ml/kg/min ± 6.2). All patients trained for 1 hour in hospital, 3 times a week during 6 months. ET-group trained endurance on five different devices that automatically adjusted load to heart rate. CT-group started each session with 40-min resistance training of 9 major muscle groups. During the first 4 months only 8 minutes were spend on endurance training with a gradual increase until 14 minutes at the end of the training programme. EC, VP and SMS was evaluatuated at baseline, after 4 and 6 months.
Results: Both groups benefited equally in terms of Maximal Workload (Wattmax) and Peak Oxygen Consumption (VO2peak). However the increase of Maximal Steady State Workload (SSW) (p=0.004) and the decrease in Heart Rate/SSW (p=0.001) was significantly greater in the CT-group. The decrease in VO2 t1/2 was significantly more pronounced in the CT-group (p=0.003). Upper Limb Strength increased with 38.2% in the CT-group versus 21.4% in the ET-group (p=0.0001). Percentage of predicted value for Maximal Expiratory Pressure (PEmax) was significantly higher (p=0.037) in the CT group.
Conclusions: Despite the fact that maximal exercise capacity (i.e.: VO2peak and Wattmax) did not differ, patients with CHF allocated to the combined endurance-resistance training group benefited more in terms of sub-maximal exercise parameters (SSW) and exercise efficiency (Heart Rate/SSW). Moreover, following this particular training programme, changes observed in Recuperation Time after maximal exercise (VO2 t1/2) and Maximal Expiratory Pressure (PEmax), both important independent prognostic determinants, were more pronounced.