Exercise training improves neurovascular control and functional capacity in heart failure patients regardless of age

2011 ◽  
Vol 19 (4) ◽  
pp. 822-829 ◽  
Author(s):  
Ligia M Antunes-Correa ◽  
Bianca Y Kanamura ◽  
Ruth C Melo ◽  
Thais S Nobre ◽  
Linda M Ueno ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Flow ◽  
Exercise Training ◽  
Functional Capacity ◽  
Muscle Sympathetic Nerve Activity ◽  
Venous Occlusion ◽  
Cardiopulmonary Exercise Test ◽  
Middle Aged ◽  
Aged Patients ◽  
Heart Failure Patients

Background: Exercise training is a non-pharmacological strategy for treatment of heart failure. Exercise training improves functional capacity and quality of life in patients. Moreover, exercise training reduces muscle sympathetic nerve activity (MSNA) and peripheral vasoconstriction. However, most of these studies have been conducted in middle-aged patients. Thus, the effects of exercise training in older patients are much less understood. The present study was undertaken to investigate whether exercise training improves functional capacity, muscular sympathetic activation and muscular blood flow in older heart failure patients, as it does in middle-aged heart failure patients. Design: Fifty-two consecutive outpatients with heart failure from the database of the Unit of Cardiovascular Rehabilitation and Physiology Exercise were divided by age (middle-aged, defined as 45–59 years, and older, defined as 60–75 years) and exercise status (trained and untrained). Methods: MSNA was recorded directly from the peroneal nerve using the microneurography technique. Forearm Blood Flow (FBF) was measured by venous occlusion plethysmography. Functional capacity was evaluated by cardiopulmonary exercise test. Results: Exercise training significantly and similarly increased FBF and peak VO2 in middle-aged and older heart failure patients. In addition, exercise training significantly and similarly reduced MSNA and forearm vascular resistance in these patients. No significant changes were found in untrained patients. Conclusion: Exercise training improves neurovascular control and functional capacity in heart failure patients regardless of age.

scholarly journals Patophysiologic and gender differences regarding exercise responses in decompensated heart failure patients

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
BM Delgado ◽  
ERIKA Froelicher ◽  
IVO Lopes ◽  
LUIS Sousa ◽  
ANDRÉ Novo
Keyword(s):  
Heart Failure ◽  
Gender Differences ◽  
Exercise Training ◽  
Functional Capacity ◽  
Nyha Class ◽  
Decompensated Heart Failure ◽  
Aerobic Exercise Training ◽  
Heart Failure Patients ◽  
6Mwt Distance ◽  
Class Iv

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Heart Failure patients often present impairment on their functional capacity. Exercise training is the key component of cardiac rehabilitation and must be early implemented. Knowing the characteristics that lead a patient to be a good responder to an exercise intervention would be useful to identify the ones that could benefit from this same intervention. Purpose Identify the characteristics of good responses to an aerobic exercise training in decompensated heart failure (HF) patients and understand if there are gender differences.  Methods Cross sectional study with 76 inpatients who performed an aerobic exercise training program (AET). Functional capacity was evaluated at admission and discharge using three different tools: the London Chest of Activity of Daily Living (LCADL) scale, the Barthel Index (BI) and the 6-minute walking test (6MWT). Multivariate linear regression was performed by gender to understand which variables lead a patient to have better performance. Since it is known that men and women have different responses to exercise training, the results and analysis of the data collected were performed by gender. Results Seventy-six patients (52 men) were included. The mean age was 67 ± 10 years, 15.8% were New York Heart Association (NYHA) class IV and 76.3% had reduced ejection fraction. The major etiology of HF was ischemic disease (35.5%). Six predictive equations were obtained, one for each functional capacity (FC) tool divided by gender. NYHA class III patients do not differ from class IV in terms of FC at discharge. However, HFreduced ejection fraction patients presented higher 6MWT distance (309,6m vs 231m) and lower LCADL score (11 vs 15) compared to non-reduced. Gender analysis showed that women had an average of 4 days longer in-hospital stay and a considerable difference in the 6MWT. At admission women walked 15 meters less than man and at discharge 69 meters less, presenting also lower score at BI and higher at LCADL. However, only the discharge 6MWT distance presents a statistical significant difference (69 meters; p = 0.01). Traditionally women are more sedentary and present less fitness level than men. The linear regression model shows that gender is a independent variable that contributes to the change in the 6MWT - favouring men.  Conclusions The AET program appears to be more effective in younger patients, with low FC at admission and who are less impaired. Those with left systolic ventricular function apparently interfered with progression during the program. Gender influences the performance of patients undergoing exercise training. Men present higher FC at discharge but the predictive models are stronger for women. These results are consistent with the idea that gender plays an important role in determine the performance of patients in exercise training programs.

scholarly journals Exercise Training in Heart Failure Patients With Persistent Atrial Fibrillation: a Practical Approach

2018 ◽  
Vol 4 (2) ◽  
pp. 107 ◽  
Author(s):  
Justien Cornelis ◽  
Jonathan Myers ◽  
◽  
◽  
Keyword(s):  
Heart Failure ◽  
Exercise Training ◽  
Persistent Atrial Fibrillation ◽  
Training Programme ◽  
Cardiopulmonary Exercise Test ◽  
Aerobic Exercise Training ◽  
Exercise Programmes ◽  
Training Programmes ◽  
Training Modalities

Persistent AF is present in at least 20 % of patients with chronic heart failure (CHF) and is related to a poor prognosis and more severe cardiac arrhythmias. CHF and AF share a common pathophysiology and can exacerbate one another. Exercise programmes for people with CHF have been shown to improve aerobic capacity, prognosis and quality of life. Given that patients with both CHF and AF show greater impairment in exercise performance, exercise training programmes have the potential to be highly beneficial. Optimal clinical evaluation using a cardiopulmonary exercise test should be performed before starting a training programme. Heart rate should be calculated over a longer period of time In patients with CHF and AF than those in sinus rhythm. The use of telemetry is advised to measure HR accurately during training. If telemetry is not available, patients can be safely trained based on the concomitant workload. An aerobic exercise training programme of moderate to high intensity, whether or not combined with strength training, is advised in patients with CHF and AF. Optimal training modalities and their intensity require further investigation.

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