The hemodynamic effects of isotonic exercise using hand-held weights in patients with heart failure.
BACKGROUND
Controversy surrounds the use of resistance exercise in patients with heart failure because of concerns that increases in rate-pressure product and systemic vascular resistance might lead to increased afterload and decreased cardiac output.


METHODS
Following pharmacologic left ventricular unloading therapy using a pulmonary artery catheter, 34 patients with advanced heart failure performed isotonic weightlifting exercise at 50%, 65%, and 80% of the calculated one repetition maximum. Measurements were made of hemodynamics, ST segment, rate-pressure product, serum norepinephrine, rating of perceived exertion, and dysrhythmias following each exercise set.


RESULTS
Repeated analysis of variance showed significant increases in systolic blood pressure (p = 0.0005), diastolic blood pressure (p = 0.01), rate-pressure product (p = 0.005); serum norepinephrine (p = 0.004), and rating of perceived exertion (p = 0.0005). However, systemic vascular resistance and cardiac output did not change significantly (p>0.05). Pulmonary capillary wedge pressures, the incidence of dysrhythmias, and ST segments did not significantly differ from baseline. No patients experienced angina or dyspnea during the study.


CONCLUSIONS
Isotonic exercise using hand-held weights was well tolerated hemodynamically and clinically, and no patients experienced adverse outcomes during exercise.
King
M L
ML
UCLA School of Nursing and Medicine and Ahmanson-UCLA Cardiomyopathy Center, University of California at Los Angeles, Los Angeles, California, USA.
Dracup
K A
KA
Fonarow
G C
GC
Woo
M A
MA
D000316:Adrenergic alpha-Agonists / Q000097:blood; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001145:Arrhythmias, Cardiac / Q000209:etiology; D016280:Atrial Function, Right / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D002302:Cardiac Output / Q000502:physiology; D002303:Cardiac Output, Low / Q000503:physiopathology*; D002407:Catheterization, Swan-Ganz; D015716:Electrocardiography, Ambulatory; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007551:Isotonic Contraction / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D010465:Perception / Q000502:physiology; D011669:Pulmonary Wedge Pressure / Q000502:physiology; D013318:Stroke Volume / Q000502:physiology; D014655:Vascular Resistance / Q000502:physiology; D014662:Vasoconstrictor Agents / Q000097:blood; D016277:Ventricular Function, Left / Q000502:physiology; D014891:Weight Lifting / Q000502:physiology*
D000316:Adrenergic alpha-Agonists; D014662:Vasoconstrictor Agents; D009638:Norepinephrine