title: Effects of interval cycle training with or without strength training on vascular reactivity in heart failure patients.
abstract: BACKGROUND
  Exercise training confers beneficial effects on vascular reactivity in patients with chronic heart failure (CHF). This randomized study compares the effects of interval cycle training combined with strength training versus interval training alone on vascular reactivity in CHF patients.
  
  
  METHODS
  Twenty-eight consecutive stable CHF patients (23 males, 53 ± 10 years, 28.4 ± 4.1 kg/m(2), left ventricular ejection fraction of 37 ± 12%) were randomly assigned to 3 times' weekly training sessions for 3 months, consisting of a) 40 minutes of interval cycle training (n = 14), versus b) 20 minutes of similar interval training plus 20 minutes of strength training of the quadriceps, hamstrings, muscles of the shoulder and biceps brachialis (n = 14). The work/recovery ratio of each session was 30/60 seconds. The intensity of interval training was set at 50% of the peak workload achieved at the steep ramp test (consisted of a 25-Watt increase on a cycle ergometer every 10 seconds until exhaustion). All patients underwent maximal, symptom-limited cardiopulmonary exercise testing and ultrasound evaluation of vascular reactivity by flow-mediated vasodilation (FMD) before and after the program.
  
  
  RESULTS
  A significant improvement in FMD was observed in the combined training group (P = 0.002), in contrast to the interval training alone group (P = NS); the improvement was significantly greater in the combined training than in the interval training alone group (P < .05). Peak oxygen uptake increased significantly and similarly in both groups, in the interval training group (P = .03), and in the combined training group (P = .006). No significant correlation was found between FMD improvement and cardiopulmonary exercise parameters.
  
  
  CONCLUSIONS
  A combined high-intensity, interval cycle exercise with strength training induces a greater beneficial effect on vascular reactivity rather than interval exercise training alone in CHF patients.
authors.affiliation: 1(st) Critical Care Department, Cardiopulmonary Exercise Testing and Rehabilitation Laboratory, Evgenidio Hospital, NKUA, Athens, Greece.
authors.forename: Vania
authors.initials: V
authors.lastname: Anagnostakou
authors.forename: Katerina
authors.initials: K
authors.lastname: Chatzimichail
authors.forename: Stavros
authors.initials: S
authors.lastname: Dimopoulos
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Karatzanos
authors.forename: Ourania
authors.initials: O
authors.lastname: Papazachou
authors.forename: Athanasios
authors.initials: A
authors.lastname: Tasoulis
authors.forename: Maria
authors.initials: M
authors.lastname: Anastasiou-Nana
authors.forename: Charis
authors.initials: C
authors.lastname: Roussos
authors.forename: Serafim
authors.initials: S
authors.lastname: Nanas
mesh_terms: D000328:Adult; D005080:Exercise Test / Q000379:methods*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000503:physiopathology* / Q000534:rehabilitation* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D055070:Resistance Training / Q000379:methods*; D016896:Treatment Outcome; D014664:Vasodilation / Q000502:physiology*