Moderate-Intensity Exercise Increases Subsequent Muscle Oxygenation and Speeds VO2 Kinetics in Chronic Heart Failure

2010 ◽  
Vol 42 ◽  
pp. 23
Author(s):  
T Scott Bowen ◽  
Daniel T. Cannon ◽  
Scott R. Murgatroyd ◽  
Klaus K. Witte ◽  
Harry B. Rossiter
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Muscle Oxygenation ◽  
Moderate Intensity ◽  
Moderate Intensity Exercise ◽  
Vo2 Kinetics

scholarly journals The intramuscular contribution to the slow oxygen uptake kinetics during exercise in chronic heart failure is related to the severity of the condition

2012 ◽  
Vol 112 (3) ◽  
pp. 378-387 ◽  
Author(s):  
T. Scott Bowen ◽  
Daniel T. Cannon ◽  
Scott R. Murgatroyd ◽  
Karen M. Birch ◽  
Klaus K. Witte ◽  
...  
Keyword(s):  
Heart Failure ◽  
New York ◽  
Chronic Heart Failure ◽  
Heart Association ◽  
Muscle Oxygenation ◽  
Moderate Intensity ◽  
Moderate Intensity Exercise ◽  
Warm Up ◽  
Prior Exercise ◽  
New York Heart Association

The mechanism for slow pulmonary O2 uptake (V̇o2) kinetics in patients with chronic heart failure (CHF) is unclear but may be due to limitations in the intramuscular control of O2 utilization or O2 delivery. Recent evidence of a transient overshoot in microvascular deoxygenation supports the latter. Prior (or warm-up) exercise can increase O2 delivery in healthy individuals. We therefore aimed to determine whether prior exercise could increase muscle oxygenation and speed V̇o2 kinetics during exercise in CHF. Fifteen men with CHF (New York Heart Association I–III) due to left ventricular systolic dysfunction performed two 6-min moderate-intensity exercise transitions ( bouts 1 and 2, separated by 6 min of rest) from rest to 90% of lactate threshold on a cycle ergometer. V̇o2 was measured using a turbine and a mass spectrometer, and muscle tissue oxygenation index (TOI) was determined by near-infrared spectroscopy. Prior exercise increased resting TOI by 5.3 ± 2.4% ( P = 0.001), attenuated the deoxygenation overshoot (−3.9 ± 3.6 vs. −2.0 ± 1.4%, P = 0.011), and speeded the V̇o2 time constant (τV̇o2; 49 ± 19 vs. 41 ± 16 s, P = 0.003). Resting TOI was correlated to τV̇o2 before ( R2 = 0.51, P = 0.014) and after ( R2 = 0.36, P = 0.051) warm-up exercise. However, the mean response time of TOI was speeded between bouts in half of the patients (26 ± 8 vs. 20 ± 8 s) and slowed in the remainder (32 ± 11 vs. 44 ± 16 s), the latter group having worse New York Heart Association scores ( P = 0.042) and slower V̇o2 kinetics ( P = 0.001). These data indicate that prior moderate-intensity exercise improves muscle oxygenation and speeds V̇o2 kinetics in CHF. The most severely limited patients, however, appear to have an intramuscular pathology that limits V̇o2 kinetics during moderate exercise.

scholarly journals Limitations of skeletal muscle oxygen delivery and utilization during moderate-intensity exercise in moderately impaired patients with chronic heart failure

2016 ◽  
Vol 311 (6) ◽  
pp. H1530-H1539 ◽  
Author(s):  
Victor M. Niemeijer ◽  
Ruud F. Spee ◽  
Thijs Schoots ◽  
Pieter F. F. Wijn ◽  
Hareld M. C. Kemps
Keyword(s):  
Heart Failure ◽  
Skeletal Muscle ◽  
Chronic Heart Failure ◽  
Near Infrared ◽  
Vastus Lateralis ◽  
Oxygen Uptake Kinetics ◽  
Moderate Intensity ◽  
Moderate Intensity Exercise ◽  
Exercise Tests ◽  
Mean Response Time

The extent and speed of transient skeletal muscle deoxygenation during exercise onset in patients with chronic heart failure (CHF) are related to impairments of local O2 delivery and utilization. This study examined the physiological background of submaximal exercise performance in 19 moderately impaired patients with CHF (Weber class A, B, and C) compared with 19 matched healthy control (HC) subjects by measuring skeletal muscle oxygenation (SmO2) changes during cycling exercise. All subjects performed two subsequent moderate-intensity 6-min exercise tests (bouts 1 and 2) with measurements of pulmonary oxygen uptake kinetics and SmO2 using near-infrared spatially resolved spectroscopy at the vastus lateralis for determination of absolute oxygenation values, amplitudes, kinetics (mean response time for onset), and deoxygenation overshoot characteristics. In CHF, deoxygenation kinetics were slower compared with HC (21.3 ± 5.3 s vs. 16.7 ± 4.4 s, P < 0.05, respectively). After priming exercise (i.e., during bout 2), deoxygenation kinetics were accelerated in CHF to values no longer different from HC (16.9 ± 4.6 s vs. 15.4 ± 4.2 s, P = 0.35). However, priming did not speed deoxygenation kinetics in CHF subjects with a deoxygenation overshoot, whereas it did reduce the incidence of the overshoot in this specific group ( P < 0.05). These results provide evidence for heterogeneity with respect to limitations of O2 delivery and utilization during moderate-intensity exercise in patients with CHF, with slowed deoxygenation kinetics indicating a predominant O2 utilization impairment and the presence of a deoxygenation overshoot, with a reduction after priming in a subgroup, indicating an initial O2 delivery to utilization mismatch.

scholarly journals Exercise training modalities in chronic heart failure: does high intensity aerobic interval training make the difference?

2016 ◽  
Vol 86 (1-2) ◽  
Author(s):  
Francesco Giallauria ◽  
Neil Andrew Smart ◽  
Antonio Cittadini ◽  
Carlo Vigorito
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Exercise Training ◽  
Exercise Capacity ◽  
High Intensity ◽  
Moderate Intensity ◽  
Exercise Session ◽  
Moderate Intensity Exercise ◽  
Training Modalities ◽  
The Impact

Exercise training (ET) is strongly recommended in patients with chronic heart failure (CHF). Moderate-intensity aerobic continuous ET is the best established training modality in CHF patients. In the last decade, however, high-intensity interval exercise training (HIIT) has aroused considerable interest in cardiac rehabilitation community. Basically, HIIT consists of repeated bouts of high-intensity exercise alternated with recovery periods. In CHF patients, HIIT exerts larger improvements in exercise capacity compared to moderate-continuous ET. These results are intriguing, mostly considering that better functional capacity translates into an improvement of symptoms and quality of life. Notably, HIIT did not reveal major safety issues; although CHF patients should be clinically stable, have had recent exposure to at least regular moderate-intensity exercise, and appropriate supervision and monitoring during and after the exercise session are mandatory. The impact of HIIT on cardiac dimensions and function and on endothelial function remains uncertain. HIIT should not replace other training modalities in heart failure but should rather complement them. Combining and tailoring different ET modalities according to each patient’s baseline clinical characteristics (i.e. exercise capacity, personal needs, preferences and goals) seem the most astute approach to exercise prescription.

Moderate-intensity exercise training with elements of step aerobics in patients with severe chronic heart failure

1999 ◽  
Vol 80 (7) ◽  
pp. 746-750 ◽  
Author(s):  
Barbara Sturm ◽  
Michael Quittan ◽  
Günther F. Wiesinger ◽  
Brigitte Stanek ◽  
Bernhard Frey ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Exercise Training ◽  
Moderate Intensity ◽  
Moderate Intensity Exercise ◽  
Severe Chronic Heart Failure

Confirming a beneficial effect of the six-minute walk test on exercise confidence in patients with heart failure

2019 ◽  
Vol 19 (2) ◽  
pp. 165-171 ◽  
Author(s):  
SR Toukhsati ◽  
S Mathews ◽  
A Sheed ◽  
I Freijah ◽  
L Moncur ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mixed Model ◽  
Moderate Intensity ◽  
Future Research ◽  
Walk Test ◽  
Clinical Tool ◽  
Moderate Intensity Exercise ◽  
Heart Failure Patients ◽  
Six Minute Walk Test ◽  
Minute Walk

Background: Low confidence to exercise is a barrier to engaging in exercise in heart failure patients. Participating in low to moderate intensity exercise, such as the six-minute walk test, may increase exercise confidence. Aim: To compare the effects of a six-minute walk test with an educational control condition on exercise confidence in heart failure patients. Methods: This was a prospective, quasi-experimental design whereby consecutive adult patients attending an out-patient heart failure clinic completed the Exercise Confidence Scale prior to and following involvement in the six-minute walk test or an educational control condition. Results: Using a matched pairs, mixed model design ( n=60; 87% male; Mage=58.87±13.16), we identified a significantly greater improvement in Total exercise confidence ( F(1,54)=4.63, p=0.036, partial η2=0.079) and Running confidence ( F(1,57)=4.21, p=0. 045, partial η2=0.069) following the six-minute walk test compared to the educational control condition. These benefits were also observed after adjustment for age, gender, functional class and depression. Conclusion: Heart failure patients who completed a six-minute walk test reported greater improvement in exercise confidence than those who read an educational booklet for 10 min. The findings suggest that the six-minute walk test may be used as a clinical tool to improve exercise confidence. Future research should test these results under randomized conditions and examine whether improvements in exercise confidence translate to greater engagement in exercise behavior.

The Effect of Hyperoxia on Slowed VO2 Kinetics In the Upper Region of Moderate-Intensity Exercise

2008 ◽  
Vol 40 (Supplement) ◽  
pp. S115
Author(s):  
Lisa M. K. Chin ◽  
P Jonathan Pace ◽  
Caitlin Symonette ◽  
Harry B. Rossiter ◽  
Donald H. Paterson ◽  
...  
Keyword(s):  
Moderate Intensity ◽  
Moderate Intensity Exercise ◽  
Vo2 Kinetics

scholarly journals Acute impact of conventional and eccentric cycling on platelet and vascular function in patients with chronic heart failure

2017 ◽  
Vol 122 (6) ◽  
pp. 1418-1424 ◽  
Author(s):  
Andrew Haynes ◽  
Matthew D. Linden ◽  
Lauren C. Chasland ◽  
Kazunori Nosaka ◽  
Andrew Maiorana ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Platelet Function ◽  
Vascular Function ◽  
Acute Exercise ◽  
Moderate Intensity ◽  
Reduced Ejection Fraction ◽  
Exercise Modality ◽  
Flow Cytometric ◽  
Evidence Based Guidelines

Evidence-based guidelines recommend exercise therapy for patients with chronic heart failure (CHF). Such patients have increased atherothrombotic risk. Exercise can transiently increase platelet activation and reactivity and decrease vascular function in healthy participants, although data in CHF are scant. Eccentric (ECC) cycling is a novel exercise modality that may be particularly suited to patients with CHF, but the acute impacts of ECC cycling on platelet and vascular function are currently unknown. Our null hypothesis was that ECC and concentric (CON) cycling, performed at matched external workloads, would not induce changes in platelet or vascular function in patients with CHF. Eleven patients with heart failure with reduced ejection fraction (HFrEF) took part in discrete bouts of ECC and CON cycling. Before and immediately after exercise, vascular function was assessed by measuring diameter and flow-mediated dilation (FMD) of the brachial artery. Platelet function was measured by the flow cytometric determination of glycoprotein IIb/IIIa activation and granule exocytosis in the presence and absence of platelet agonists. ECC cycling increased baseline artery diameter (pre: 4.0 ± 0.8 mm vs. post: 4.2 ± 0.7 mm; P = 0.04) and decreased FMD%. When changes in baseline artery diameter were accounted for, the decrease in FMD post-ECC cycling was no longer significant. No changes were apparent after CON. Neither ECC nor CON cycling resulted in changes to any platelet-function measures (all P > 0.05). These results suggest that both ECC and CON cycling, at a moderate intensity and short duration, can be performed by patients with HFrEF without detrimental impacts on vascular or platelet function. NEW & NOTEWORTHY This is the first evidence to indicate that eccentric (ECC) cycling can be performed relatively safely by patients with chronic heart failure (CHF), as it did not result in impaired vascular or platelet function compared with conventional cycling. This is important, as acute exercise can transiently increase atherothrombotic risk, and ECC cycling is a novel exercise modality that may be particularly suited to patients with CHF.

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