HIGH-INTENSITY PROGRESSIVE RESISTANCE TRAINING IN OLDER WOMEN WITH CHRONIC HEART FAILURE 846

Abstract

Impaired skeletal muscle performance (MP; strength and endurance) have been reported and correlated to reduced exercise capacity (EC) in chronic heart failure (CHF) patients due to left ventricular systolic dysfunction (LVSD). Improvements in MP and EC have been shown with aerobic exercise training in mostly younger, male CHF patients. The efficacy and safety of strength training in CHF patients with LVSD are not well-described. The effects of resistive exercise in an older, frailer population with CHF are unknown. Therefore, we examined the effects of a 10 week high-intensity strength program on MP and EC in older women (mean age 76±6) with CHF due to LVSD. Nine community-dwelling subjects (mean EF% 35±5; NYHA Class 2.2±0.8; peak VO2 14.3±1.2 ml/kg; BMI 26±4 kg/m2) were randomized to either an attention control group (CON; n=4) of stretching exercises 2x/wk or a high-intensity strength training program(EX; n=5) of the chest, triceps, hip, legs and knee 3x/wk. There were no differences in baseline measures between EX and CON. Total summed (5 muscle groups) 1 RM strength increased from 150.5±14.2 psi to 205.4±16.6 psi (37.2±5.4%) in EX while remaining unchanged in CON (P<0.002). Total summed muscle endurance (number of repetitions completed at 90% of baseline 1 RM) increased from 28.2±4.5 reps to 76.0±3.6 reps (185±35%) in EX and remained the same in CON(P<0.002). There were no changes in maximal EC (peak oxygen consumption on a symptom-limited treadmill test) or rate-pressure product during submaximal EC in EX or CON. There was no deterioration in clinical status, CHF symptoms or EF% in EC or CON. These results indicate that heavy strength training is feasible and can dramatically improve muscle performance even in older, frailer CHF patients with LVSD.