TY - JOUR
T1 - Assessment of the effects of physical training in patients with chronic heart failure
T2 - The utility of effort-independent exercise variables
AU - Kemps, Hareld M.C.
AU - De Vries, Wouter R.
AU - Schmikli, Sandor L.
AU - Zonderland, Maria L.
AU - Hoogeveen, Adwin R.
AU - Thijssen, Eric J.M.
AU - Schep, Goof
PY - 2010/2
Y1 - 2010/2
N2 - Traditionally, the effects of physical training in patients with chronic heart failure (CHF) are evaluated by changes in peak oxygen uptake (peak V̇O2). The assessment of peak V̇O2, however, is highly dependent on the patients' motivation. The aim of the present study was to evaluate the clinical utility of effort-independent exercise variables for detecting training effects in CHF patients. In a prospective controlled trial, patients with stable CHF were allocated to an intervention group (N = 30), performing a 12-week combined cycle interval and muscle resistance training program, or a control group (N = 18) that was matched for age, gender, body composition and left ventricular ejection fraction. The following effort-independent exercise variables were evaluated: the ventilatory anaerobic threshold (VAT), oxygen uptake efficiency slope (OUES), the V̇E/ V̇CO2 slope and the time constant of V̇O2kinetics during recovery from submaximal constant-load exercise (τ-rec). In addition to post-training increases in peak V̇O2and peak V̇E, the intervention group showed significant within and between-group improvements in VAT, OUES and τ-rec. There were no significant differences between relative improvements of the effort-independent exercise variables in the intervention group. In contrast with VAT, which could not be determined in 9% of the patients, OUES and τ-rec were determined successfully in all patients. Therefore, we conclude that OUES and τ-rec are useful in clinical practice for the assessment of training effects in CHF patients, especially in cases of poor subject effort during symptom-limited exercise testing or when patients are unable to reach a maximal exercise level.
AB - Traditionally, the effects of physical training in patients with chronic heart failure (CHF) are evaluated by changes in peak oxygen uptake (peak V̇O2). The assessment of peak V̇O2, however, is highly dependent on the patients' motivation. The aim of the present study was to evaluate the clinical utility of effort-independent exercise variables for detecting training effects in CHF patients. In a prospective controlled trial, patients with stable CHF were allocated to an intervention group (N = 30), performing a 12-week combined cycle interval and muscle resistance training program, or a control group (N = 18) that was matched for age, gender, body composition and left ventricular ejection fraction. The following effort-independent exercise variables were evaluated: the ventilatory anaerobic threshold (VAT), oxygen uptake efficiency slope (OUES), the V̇E/ V̇CO2 slope and the time constant of V̇O2kinetics during recovery from submaximal constant-load exercise (τ-rec). In addition to post-training increases in peak V̇O2and peak V̇E, the intervention group showed significant within and between-group improvements in VAT, OUES and τ-rec. There were no significant differences between relative improvements of the effort-independent exercise variables in the intervention group. In contrast with VAT, which could not be determined in 9% of the patients, OUES and τ-rec were determined successfully in all patients. Therefore, we conclude that OUES and τ-rec are useful in clinical practice for the assessment of training effects in CHF patients, especially in cases of poor subject effort during symptom-limited exercise testing or when patients are unable to reach a maximal exercise level.
KW - Cardiac failure
KW - Ergometry
KW - Exercise training
KW - Pulmonary gas exchange
UR - http://www.scopus.com/inward/record.url?scp=76449107348&partnerID=8YFLogxK
U2 - 10.1007/s00421-009-1230-3
DO - 10.1007/s00421-009-1230-3
M3 - Article
C2 - 19834732
AN - SCOPUS:76449107348
SN - 1439-6319
VL - 108
SP - 469
EP - 476
JO - European Journal of Applied Physiology
JF - European Journal of Applied Physiology
IS - 3
ER -
