[Physical training as interval or continuous training in chronic heart failure for improving functional capacity, hemodynamics and quality of life--a controlled study].
We conducted a three-week randomized trial comparing the improvement of functional capacity by exercise training in chronic heart failure by the steady-state (EF 27.3%, n = 20) and the interval modus (EF 29.3%, n = 20) with a control group (EF = 26.6%, n = 10). Minimal EF was 10%, the lowest maximal oxygen consumption was 9.3 ml/kg/min and the lowest cardiac output was 1.9 l/min; 9 patients had been evaluated for HTX. VO2 at the anaerobic threshold and at maximal exercise increased in the continuous exercise group by 1.4 or 1.6 ml/kg/min, respectively, corresponding to an increase of 13.7% (p < 0.05) and 9.3% (p < 0.05). In the interval training group the increase was 1.3 and 1.5 ml/kg/min corresponding to 14% (p < 0.05) and 8.1% (p < 0.05). Continuous short-term exercise had no impact to central hemodynamics as pulmonary artery pressure (PA), capillary wedge pressure (pc), cardiac index (CI) or stroke volume index (SVI), whereas after interval training a significant increase at maximal exercise could be seen in CI (p < 0.05) and SVI (p < 0.01) with a concomitant drop in systemic peripheral resistance (p < 0.05) compared to the steady-state modus. Interval training was further characterized by a higher short-term but lower mean work load with a significantly smaller increase in lactate. Quality of life was improved according to the SF-36 questionnaire in both training groups but the psychologic sum factor was three times as high, increasing to 24.2% in the steady-state exercise group. It can be concluded that clinically stable patients with heart failure and even those already having been evaluated for cardiac transplantation profit from short-term physical training. Both training modalities seem equally suited to improve functional capacity. However interval training leads to more pronounced improvement in hemodynamics compared to the steady-state exercise, whereas the later had a greater impact on psychological well-being and quality of life. Patients with heart failure and severe peripheral deconditioning tolerate higher workloads with more peripheral stress by an interval training modus. Long-term training modalities need to be established to further improve and stabilize functional status.
Nechwatal
R M
RM
Christiaan-Barnard-Klinik Rehabilitationszentrum für Herz- Kreislauf-Erkrankungen Waldstr. 4, 04774 Dahlen-Schmannewitz, Germany.
Duck
C
C
Gruber
G
G
D000203:Activities of Daily Living / Q000523:psychology; D002302:Cardiac Output / Q000502:physiology; D002908:Chronic Disease; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D019344:Lactic Acid / Q000097:blood; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010101:Oxygen Consumption / Q000502:physiology; D010806:Physical Education and Training / Q000379:methods*; D010807:Physical Endurance / Q000502:physiology*; D011788:Quality of Life / Q000523:psychology
D019344:Lactic Acid
Körperliches Training als Intervall oder kontinuierliches Training bei chronischer Herzinsuffizienz zur Verbesserung der funktionellen Leistungskapazität, Hämodynamik und Lebensqualität--eine kontrollierte Studie.