308 Periodic breathing is frequent during the daytime in stable patients with heart failure and is related to impaired exercise tolerance and abnormal autonomic reflex control

Aim. Cardiac rehabilitation (CR) is an important part of heart failure (HF) treatment. The aim of this paper was to evaluate if thoracic fluid content (TFC) measured by impedance cardiography (ICG) is a useful parameter for predicting the outcome of CR.Methods. Fifty HF patients underwent clinical and noninvasive haemodynamic (TFC) assessments before and after 8-week CR.Results. As a result of CR, the patients’ exercise tolerance improved, especially in terms of peak VO2(18.7 versus 20.8 mL × kg−1× min−1;P=0.025). TFC was found to identify patients with significantly improved peak VO2after CR. “High TFC” patients (TFC > 27.0 kOhm−1), compared to those of “low TFC” (TFC < 27.0 kOhm−1), were found to have more pronounced increase in peak VO2(1.3 versus 3.1 mL × kg−1× min−1;P=0.011) and decrease in TFC (4.0 versus 0.7 kOhm−1;P<0.00001). On the other hand, the patients with improved peak VO2(n=32) differed from those with no peak VO2improvement in terms of higher baseline TFC values (28.4 versus 25.3 kOhm−1;P=0.039) and its significant decrease after CR (2.7 versus 0.2 kOhm−1;P=0.012).Conclusions. TFC can be a useful parameter for predicting beneficial effects of CR worth including in the process of patients’ qualification for CR.

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Effects of continuous physical training on exercise tolerance and left ventricular myocardial function in patients with heart failure

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0710516d ◽

2007 ◽

Vol 135 (9-10) ◽

pp. 516-520 ◽

Cited By ~ 1

Author(s):

Marina Deljanin-Ilic ◽

Stevan Ilic ◽

Viktor Stoickov

Keyword(s):

Heart Failure ◽

Ejection Fraction ◽

Physical Training ◽

Exercise Tolerance ◽

Myocardial Function ◽

Left Ventricular ◽

Rehabilitation Programme ◽

Patients With Heart Failure ◽

Lv Ejection Fraction ◽

Residential Rehabilitation

Introduction Physical training is an important method in the rehabilitation programme for cardiovascular patients. Nevertheless, some controversies about physical training in patients with heart failure still exist. Objective The aim of the study was to assess the effects of continuous physical training on exercise tolerance, ejection fraction and regional systolic and diastolic left ventricular (LV) myocardial function in patients with stable heart failure. Method The study involved 48 male patients with stable heart failure and LV ejection fraction ?35% determined by echocardiography. At the end of a two-week residential rehabilitation programme, the patients were divided in two groups. The group of 27 patients (T group) continued with regular physical training (4 to 5 times weekly) during 6 months, while 21 patients (K group) did not have regular physical training. In all patients, the exercise test and echocardiography studies were performed after residential rehabilitation and 6 months later. Regional myocardial function of LV was evaluated by the pulsed wave tissue Doppler imaging. Results After 6 months, an increase in exercise tolerance was more significant in T group. LV ejection fraction increased significantly (p<0.05) only in T group. After six months, in T group, regional systolic (p<0.01) and diastolic (p<0.005) myocardial function improved significantly, while in K group a significant improvement was seen only for regional diastolic function (p<0.05), and it was less than in T group. Conclusion The results of our study suggest that continuous physical training during the period of 6 months in patients with stable heart failure induced significant improvement of exercise tolerance, ejection fraction and regional systolic and diastolic LV myocardial function.

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Effects of Dietary Inorganic Nitrate Supplementation on Exercise Performance in Patients With Heart Failure: Protocol for a Randomized, Placebo-Controlled, Cross-Over Trial (Preprint)

10.2196/preprints.8865 ◽

2017 ◽

Author(s):

Mary N. Woessner ◽

Itamar Levinger ◽

Christopher Neil ◽

Cassandra Smith ◽

Jason D Allen

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Exercise Test ◽

Exercise Tolerance ◽

Cardiopulmonary Exercise Test ◽

Cardiopulmonary Exercise ◽

Inorganic Nitrate ◽

Patients With Heart Failure ◽

Nitrate Supplementation ◽

Nitric Oxide Bioavailability

BACKGROUND Chronic heart failure is characterized by an inability of the heart to pump enough blood to meet the demands of the body, resulting in the hallmark symptom of exercise intolerance. Chronic underperfusion of the peripheral tissues and impaired nitric oxide bioavailability have been implicated as contributors to the decrease in exercise capacity in these patients. nitric oxide bioavailability has been identified as an important mediator of exercise tolerance in healthy individuals, but there are limited studies examining the effects in patients with chronic heart failure. OBJECTIVE The proposed trial is designed to determine the effects of chronic inorganic nitrate supplementation on exercise tolerance in both patients with heart failure preserved ejection fraction (HFpEF) and heart failure reduced ejection fraction (HFrEF) and to determine whether there are any differential responses between the 2 cohorts. A secondary objective is to provide mechanistic insights into the 2 heart failure groups’ exercise responses to the nitrate supplementation. METHODS Patients with chronic heart failure (15=HFpEF and 15=HFrEF) aged 40 to 85 years will be recruited. Following an initial screen cardiopulmonary exercise test, participants will be randomly allocated in a double-blind fashion to consume either a nitrate-rich beetroot juice (16 mmol nitrate/day) or a nitrate-depleted placebo (for 5 days). Participants will continue daily dosing until the completion of the 4 testing visits (maximal cardiopulmonary exercise test, submaximal exercise test with echocardiography, vascular function assessment, and vastus lateralis muscle biopsy). There will then be a 2-week washout period after which the participants will cross over to the other treatment and complete the same 4 testing visits. RESULTS This study is funded by National Heart Foundation of Australia and Victoria University. Enrolment has commenced and the data collection is expected to be completed in mid 2018. The initial results are expected to be submitted for publication by the end of 2018. CONCLUSIONS If inorganic nitrate supplementation can improve exercise tolerance in patients with chronic heart failure, it has the potential to aid in further refining the treatment of patients in this population. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12615000906550; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=368912 (Archived by WebCite at http://www.webcitation.org/6xymLMiFK)

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Application of Inspiratory Muscle Training to Improve Physical Tolerance in Older Patients with Ischemic Heart Failure

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182312441 ◽

2021 ◽

Vol 18 (23) ◽

pp. 12441

Author(s):

Monika Piotrowska ◽

Paulina Okrzymowska ◽

Wojciech Kucharski ◽

Krystyna Rożek-Piechura

Keyword(s):

Heart Failure ◽

Muscle Strength ◽

Cardiac Rehabilitation ◽

Exercise Tolerance ◽

Respiratory Muscle ◽

Inspiratory Muscle ◽

Inspiratory Muscle Training ◽

Respiratory Muscle Strength ◽

Muscle Training ◽

Patients With Heart Failure

Regardless of the management regime for heart failure (HF), there is strong evidence supporting the early implementation of exercise-based cardiac rehabilitation (CR). Respiratory therapy is considered to be an integral part of such secondary prevention protocols. The aim of the study was to evaluate the effect of inspiratory muscle training (IMT) on exercise tolerance and the functional parameters of the respiratory system in patients with heart failure involved in cardiac rehabilitation. The study included 90 patients with HF who took part in the second-stage 8-week cycle of cardiac rehabilitation (CR). They were randomly divided into three groups: Group I underwent CR and IMT; Group II only CR; and patients in Group III underwent only the IMT. Before and after the 8-week cycle, participants were assessed for exercise tolerance and the functional parameters of respiratory muscle strength. Significant statistical improvement concerned the majority of the hemodynamic parameters, lung function parameters, and respiratory muscle strength in the first group. Moreover, the enhancement in the exercise tolerance in the CR + IMT group was accompanied by a negligible change in the HRpeak. The results confirm that the addition of IMT to the standard rehabilitation process of patients with heart failure can increase the therapeutic effect while influencing some of the parameters measured by exercise electrocardiography and respiratory function.

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