Interval exercise training improves tissue oxygenation in patients with chronic heart failure
Ioannis Vasileiadis, Maria Kravari, John Terrovitis, Vasiliki Gerovasili, Stavros Drakos, Argyrios Ntaliannis, Stavros Dimopoulos, Maria Anastasiou-Nana, Serafim Nanas
Pulmonary & Critical Care Medicine Department, Cardiopulmonary Exercise Testing and Rehabilitation Laboratory, “Evgenidio” Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Pulmonary & Critical Care Medicine Department, Cardiopulmonary Exercise Testing and Rehabilitation Laboratory, “Evgenidio” Hospital, National and Kapodistrian University of Athens, Athens, Greece..
Third Cardiology Department, National and Kapodistrian University of Athens, Athens, Greece.
Third Cardiology Department, National and Kapodistrian University of Athens, Athens, Greece..
DOI: 10.4236/wjcd.2013.31A019   PDF    HTML   XML   3,167 Downloads   5,480 Views   Citations

Abstract

Aim: Aim of our study was to evaluate the effects of interval exercise training (IT) programs, regarding whole body oxygen uptake and peripheral tissue oxygenation, in Chronic Heart Failure (CHF) patients during recovery. Methods: Twenty-six CHF patients (21 males/5 females), mean age of 49 ± 12 years, participated in the study. Fifteen patients were assigned to IT and 11 patients were assigned to IT followed by strength training. All patients were trained for 40 minutes per session, 3 times per week, for 12 weeks. They performed a symptom-limited cardiopulmonary exercise testing (CPET), before and after the completion of the program. Muscle tissue oxygen saturation (StO2) of quadriceps femoris was continuously measured by Near Infrared Spectroscopy (NIRS) during CPET and during the recovery period after the end of exercise. Results: No differences were noted between the two patient groups regarding whole body and peripheral tissue oxygenation indices and, therefore, data from all patients were pooled. After training, an increase in peak oxygen uptake (17 ± 4.5 to 19 ± 5.5 ml/kg/min, p < 0.05), gas exchange threshold (11 ± 3.5 to 12.5 ± 3.5 ml/kg/min, p < 0.05), peak work rate achieved (105 ± 29 to 124 ± 37 Watt, p < 0.05) and the first degree slope of VO2 at the first minute of recovery (0.45 ± 0.2 to 0.61 ±0.3 L/min2, p < 0.05), was noted. In addition, tissue re-oxygenation time constant was decreased (65 ± 25 to 52 ± 28 sec, p < 0.001). Conclusion: In conclusion, interval exercise training accelerates oxygen uptake and peripheral tissue oxygenation during recovery from exercise in CHF patients.

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Vasileiadis, I. , Kravari, M. , Terrovitis, J. , Gerovasili, V. , Drakos, S. , Ntaliannis, A. , Dimopoulos, S. , Anastasiou-Nana, M. and Nanas, S. (2013) Interval exercise training improves tissue oxygenation in patients with chronic heart failure. World Journal of Cardiovascular Diseases, 3, 126-132. doi: 10.4236/wjcd.2013.31A019.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Duscha, B.D., Schulze, P.C., Robbins, J.L. and Forman, D.E. (2008) Implications of chronic heart failure on peripheral vasculature and skeletal muscle before and after exercise training. Heart Failure Reviews, 13, 21-37. doi:10.1007/s10741-007-9056-8
[2] Chong, A.Y., Blann, A.D., Patel, J., Freestone, B., Hughes, E. and Lip, G.Y. (2004) Endothelial dysfunction and damage in congestive heart failure. Relation of flow-mediated dilation to circulating endothelial cells, plasma indexes of endothelial damage, and brain natriuretic peptide. Circulation, 110, 1794-1798. doi:10.1161/01.CIR.0000143073.60937.50
[3] Houben, A.J., Beliaars, J.H., Hofstra, L., Kroon, A.A. and De Leeuw, P.W. (2003) Microvascular abnormalities in chronic heart failure: A cross sectional analysis. Micro-circulation, 10, 471-478.
[4] Van Tol, B.A.F., Huijsmans, R.J., Kroon, D.W., Schothorst, M. and Kwakkel, G. (2006) Effects of exercise training on cardiac performance, exercise capacity and quality of life in patients with heart failure: A meta- analysis. European Journal of Heart Failure, 8, 841-850. doi:10.1016/j.ejheart.2006.02.013
[5] Niebauer, J., Clark, A.L., Webb-Peploe, K.M. and Coats, A.J. (2005) Exercise training in chronic heart failure: Effects on pro-inflammatory markers. European Journal of Heart Failure, 7, 189-193. doi:10.1016/j.ejheart.2004.07.012
[6] Roditis, P., Dimopoulos, S., Sakellariou, D., et al. (2007) The effects of exercise training on the kinetics of oxygen uptake in patients with chronic heart failure. European Journal of Cardiovascular Prevention and Rehabilitation, 14, 304-311.
[7] Meyer, K., Samek, L., Schwaibold, M., et al. (1997) Interval training in patients with severe chronic heart failure: Analysis and recommendations for exercise procedures. Medicine & Science in Sports & Exercise, 29, 306-312. doi:10.1097/00005768-199703000-00004
[8] Meyer, K. (2001) Exercise training in heart failure: Recommendations based on current research. Medicine & Science in Sports & Exercise, 33, 525-531. doi:10.1097/00005768-200104000-00004
[9] Bouchla, A., Karatzanos, E., Dimopoulos, S., et al. (2011) The addition of strength training on aerobic interval training program: Effects on muscle strength and body composition in CHF patients. Journal of Cardiopulmonary Rehabilitation and Prevention, 31, 47-51.
[10] Grassi, B., Pogliaghi, S., Rampichini, S., et al. (2003) Muscle oxygenation and pulmonary gas exchange kinetics during cycling exercise on-transitions in humans. Journal of Applied Physiology, 95, 149-158.
[11] Lima, A. and Bakker, J. (2005) Noninvasive monitoring of peripheral perfusion. Intensive Care Medicine, 31, 1316-1326. doi:10.1007/s00134-005-2790-2
[12] Cohen-Solal, A., Laperche, T., Morvan, D., Geneves, M., Caviezel, B. and Gourgon, R. (1995) Prolonged kinetics of recovery of oxygen consumption after maximal graded exercise in patients with chronic heart failure. Circulation, 91, 2924-2932. doi:10.1161/01.CIR.91.12.2924
[13] Boushel, R. and Piantadosi, C.A. (2000) Near-infrared spectroscopy for monitoring muscle oxygenation. Acta Physiologica Scandinavica, 168, 615-622. doi:10.1046/j.1365-201x.2000.00713.x
[14] Hiroyuki, H., Hamaoka, T., Sako, T., et al. (2002) Oxygenation in vastus lateralis and lateral head of gastrocnemius during treadmill walking and running in humans. European Journal of Applied Physiology, 87, 343-349. doi:10.1007/s00421-002-0644-y
[15] Neary, J.P., Hall, K. and Bhambhani, Y.N. (2001) Vastus medialis muscle oxygenation trends during a simulated 20-km cycle time trial. European Journal of Applied Physiology, 85, 427-33. doi:10.1007/s004210100481
[16] Kravari, M., Angelopoulos, E., Vasileiadis, I., Gerovasili, V. and Nanas, S. (2010) Monitoring tissue oxygenation during exercise with near infrared spectroscopy in diseased populations—A brief review. International Journal of Industrial Ergonomics, 40, 223-227. doi:10.1016/j.ergon.2009.02.002
[17] Hansen, J.E., Sue, D.Y. and Wasserman, K. (1984) Predicted values for clinical exercise testing. The American Review of Respiratory Disease, 129, S49-S55.
[18] Beaver, W.L., Wasserman, K. and Whipp, B.J. (1986) A new method for detecting anaerobic threshold by gas exchange. Journal of Applied Physiology, 60, 2020-2027.
[19] Nanas, S., Nanas, J., Kassiotis, C., et al. (2001) Early recovery of oxygen kinetics after submaximal exercise test predicts functional capacity in patients with chronic heart failure. European Journal of Heart Failure, 3, 685-692. doi:10.1016/S1388-9842(01)00187-8
[20] Cohen-Solal, A., Chabernaud, J.M. and Gourgon, R. (1990) Comparison of oxygen uptake during bicycle exercise in patients with chronic heart failure and in normal subjects. Journal of the American College of Cardiology, 16, 80-85. doi:10.1016/0735-1097(90)90460-7
[21] Belardinelli, R., Barstow, T.J., Nguyen, P. and Wasserman, K. (1997) Skeletal muscle oxygenation and oxygen uptake kinetics following constant work rate exercise in chronic congestive heart failure. American Journal of Cardiology, 80, 1319-1324. doi:10.1016/S0002-9149(97)00672-3
[22] Kravari, M., Vasileiadis, I., Gerovasili, V., et al. (2010) Effects of a 3-month rehabilitation program on muscle oxygenation in congestive heart failure patients as assessed by NIRS. International Journal of Industrial Ergonomics, 40, 212-217. doi:10.1016/j.ergon.2009.03.006
[23] Kemps, H.M., De Vries, W.R., Hoogeveen, A.R., Zonderland, M.L., Thijssen, E.J. and Schep, G. (2007) Reproducibility of onset and recovery oxygen uptake kinetics in moderately impaired patients with chronic heart failure. European Journal of Applied Physiology, 100, 45-52. doi:10.1007/s00421-007-0398-7
[24] Dimopoulos, S., Anastasiou-Nana, M., Sakellariou, D., et al. (2006) Effects of exercise rehabilitation program on heart rate recovery in patients with chronic heart failure. European Journal of Cardiovascular Prevention and Rehabilitation, 13, 67-73.
[25] Wislφff, U., Stφylen, A., Loennechen, J.P., et al. (2007) Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients: A randomized study. Circulation, 115, 3086-3094. doi:10.1161/CIRCULATIONAHA.106.675041
[26] Anagnostakou, V., Chatzimichail, K., Dimopoulos, S., et al. (2011) Effects of interval cycle training with or without strength training on vascular reactivity in heart failure patients. Journal of Cardiac Failure, 17, 585-591. doi:10.1016/j.cardfail.2011.02.009
[27] Hanada, A., Okita, K., Yonezava, K., et al. (2000) Dissociation between muscle metabolism and oxygen kinetics during recovery from exercise in patients with chronic heart failure. Heart, 83, 161-166. doi:10.1136/heart.83.2.161
[28] Kemps, H.M., Schep, G., Zonderland, M.L., et al. (2009) Are oxygen uptake kinetics in chronic heart failure limited by oxygen delivery or oxygen utilization? International Journal of Cardiology, 142, 138-144. doi:10.1016/j.ijcard.2008.12.088
[29] Braith, R.W., Welsch, M.A., Feigenbaum, M.S., Kluess, H.A. and Pepine, C.J. (1999) Neuroendocrine activation in heart failure is modified by endurance exercise training. Journal of the American College of Cardiology, 34, 1170-1175. doi:10.1016/S0735-1097(99)00339-3
[30] Roveda, F., Middlekauff, H.R., Rondon, M.U., et al. (2003) The effects of exercise training on sympathetic neural activation in advanced heart failure: a randomized controlled trial. Journal of the American College of Cardiology, 42, 854-860. doi:10.1016/S0735-1097(03)00831-3
[31] Hambrecht, R., Niebauer, J., Fiehn, E., et al. (1995) Physical training in patients with stable chronic heart failure: Effects on cardiorespiratory fitness and ultrastructural abnormalities in leg muscles. Journal of the American College of Cardiology, 25, 1239-1249. doi:10.1016/0735-1097(94)00568-B
[32] Adamopoulos, S., Coats, A.J., Brunotte, F., et al. (1993) Physical training improves skeletal muscle metabolism in patients with chronic heart failure. Journal of the American College of Cardiology, 21, 1101-1106. doi:10.1016/0735-1097(93)90231-O
[33] Rossiter, H.B., Ward, S.A., Kowalchuk, J.M., Howe, F.A., Griffiths, J.R. and Whipp, B.J. (2002) Dynamic asymmetry of phosphocreatine concentration and O2 uptake between the on- and off-transients of moderate- and high- intensity exercise in humans. The Journal of Physiology, 541, 991-1002. doi:10.1113/jphysiol.2001.012910

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