title: Effect of aerobic interval training on erythrocyte rheological and hemodynamic functions in heart failure patients with anemia.
abstract: BACKGROUND
  Anemia disturbs hemorheological/hemodynamic properties, whereas aerobic interval training (AIT) achieves a superior aerobic fitness in patients with heart failure (HF). This study investigated whether AIT influences functional capacity by modulating hemorheological/hemodynamic functions in HF patients with/without anemia.
  
  
  METHODS
  Sixty HF patients were divided into non-anemic (HF-NA, hemoglobin >/= 12 g/dL in women/ >/= 13 g/dL in men; n=30) and anemic (HF-A, hemoglobin<11 g/dL in women/<12 g/dL in men; n=30) groups, and 30 normal counterparts were enrolled as a control group. These HF patients performed AIT (3-minute intervals at 40% and 80%VO(2peak)) on a bicycle ergometer for 30 min/day, 3 days/week for 12 weeks. Erythrocyte rheological and central/peripheral hemodynamic characteristics were determined by slit-flow ektacytometer and bioreactance-based device/near infrared spectrometer, respectively.
  
  
  RESULTS
  In both HF-NA and HF-A groups, the AIT regimen 1) reduced blood senescent/spherical erythrocyte counts, 2) diminished the values of critical shear stresses for disaggregation and half-maximal deformation of erythrocytes, 3) enhanced cardiac output during exercise, 4) heightened VO(2peak) and O2 uptake efficiency slope (OUES), and 5) decreased plasma myeloperoxidase and interleukin-6 levels. However, AIT increased the amounts of blood distributed to the frontal cerebral lobe and vastus lateralis muscle during exercise in HF-NA group but not in HF-A group. Additionally, HF-A group exhibited fewer the enhancements of VO(2peak) and OUES caused by AIT than HF-NA group did.
  
  
  CONCLUSIONS
  AIT improves aerobic capacity and efficiency by depressing aggregability and enhancing deformability of erythrocytes in patients with HF. However, anemic comorbidity attenuates the adaptations of cerebral/muscular hemodynamic responses to exercise following this regimen.
authors.affiliation: Healthy Aging Research Center, Graduate Institute of Rehabilitation Science, Chang Gung University, Tao-Yuan, Taiwan. Electronic address: s5492@mail.cgu.edu.tw.
authors.forename: Jong-Shyan
authors.initials: JS
authors.lastname: Wang
authors.forename: Tieh-Cheng
authors.initials: TC
authors.lastname: Fu
authors.forename: Hen-Yu
authors.initials: HY
authors.lastname: Lien
authors.forename: Chao-Hung
authors.initials: CH
authors.lastname: Wang
authors.forename: Chih-Chin
authors.initials: CC
authors.lastname: Hsu
authors.forename: Wei-Chin
authors.initials: WC
authors.lastname: Wu
authors.forename: Yu-Wen
authors.initials: YW
authors.lastname: Chien
authors.forename: Wen-Jin
authors.initials: WJ
authors.lastname: Cherng
mesh_terms: D000368:Aged; D000740:Anemia / Q000097:blood* / Q000453:epidemiology / Q000628:therapy*; D048430:Cell Shape / Q000502:physiology; D004912:Erythrocytes / Q000502:physiology*; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test / Q000379:methods; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000453:epidemiology / Q000628:therapy*; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012212:Rheology / Q000379:methods*; D016896:Treatment Outcome