Resistance training for chronic heart failure patients on beta blocker medications☆
Introduction
A reduction of aerobic capacity and a decrease of skeletal muscle mass and strength are characteristics of chronic heart failure patients [1], [2]. It is widely accepted that changes in skeletal muscle structure, such as muscle atrophy and muscle fiber alteration [1], and in metabolism, such as a reduction in oxidative enzymes activities and early anaerobic metabolism [3], [4], are major contributors to these phenomena. The role of resistance training in heart disease patients is to promote dynamic skeletal muscle strength [5] with an associated decrease in the numbers of falls and injuries related to falls with an improved functional ability of elderly and chronic heart failure patients [6], [7], [8].
Beta-blocker therapy is considered a standard therapy for people with chronic heart failure [9]. It was shown that beta-blocker therapy reduces the clinical progress of the disease [10], decreases the heart rate and blood pressure and increases the ejection fraction and improves the quality of life [11], [12]. However, despite these improvements peak oxygen consumption (peak VO2) and exercise capacity has not consistently improved following beta-blocker therapy [13], [14].
Previous studies demonstrated a correlation between peak VO2 and muscle mass (r between 0.57 and 0.71) [15], [16], [17] which suggests that resistance training may improve the aerobic capacity of people with chronic heart failure [1]. However, studies that examined the effect of resistance training on peak VO2 of chronic heart failure patients on beta-blocker medications are limited and the data available for other cardiac populations is inconclusive [18], [19], [20], [21]. The inconsistencies between the studies regarding the effect of resistance training on peak VO2 may be as a result of the different types of training protocols used (intensities, length and duration of the program) and the different types of cardiac patients. Hence, the purpose of this study was to examine the effect of resistance training on peak aerobic capacity, muscle strength and quality of life of chronic heart failure patients on beta-blocker medication.
Section snippets
Method
Fifteen men with mean (±SD) age 57.0±10.2 years diagnosed with chronic heart failure (ejection fraction=34.7±7.2) and treated with beta-blockers for at least 3 months volunteered to participate in the study. Subjects were matched to either a resistance training program (n=8) or non-training control group (n=7) according to their age and ejection fraction. The study protocol was approved by the Human Research Ethics Committee, Southern Cross University (ECN-02-110) and John Flynn Private
Baseline comparison
No differences were found between the groups at baseline for age, weight, height, ejection fraction, peak VO2 and total weight lifted in the maximal strength test (groups' clinical characteristics are shown in Table 1). The beta-blocker doses were slightly changed in two subjects during the study. All subjects completed 8 weeks of training without injuries or muscle soreness. No adverse effects were recorded during and for 24 h after the tests or during the training. Four subjects did not
Discussion
There is limited data in the literature reporting the effect of progressive resistance training on chronic heart failure patients in general and for those on beta-blocker medication in particular. Studies that examined the effect of resistance training on cardiac and chronic heart failure patients also involved some degree of aerobic training (such as circuit weight training) [27], [28]. Although these studies demonstrated significant improvement in the patient's strength and functional
Acknowledgments
This study was partly funded by Roche Products NSW, Australia. The authors wishes to thank Elite Fitness Group, Australia for contributing the resistance equipment. Ms. Karen Gosper for her assistance in recruiting the subjects and Mrs. Debbie Humphreys for her assistance during the testing procedures.
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2015, American Journal of Kidney DiseasesCitation Excerpt :The improvement in Vo2peak following the resistance training intervention was unexpected considering that Vo2peak is a measure of cardiorespiratory function. However, it has been suggested that enhanced work capacity also requires muscular strength and anaerobic power.31-34 All participants terminated the Vo2peak test before their cardiovascular system was maximally stressed.
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Grant: the study was partly supported by Roche Products, NSW, Australia.