Resistance training improves vasoreactivity in end-stage heart failure patients on inotropic support

J Cardiovasc Nurs. 2011 May-Jun;26(3):218-23. doi: 10.1097/JCN.0b013e3181f29a46.

Abstract

Purpose: Peripheral vascular abnormalities contribute to compromised functional status in heart failure (HF) patients. The purpose of the present study was to test whether the intervention of moderate-intensity, resistance training could improve peripheral vascular responsiveness, that is, flow-mediated dilation (FMD) in HF.

Methods: Baseline brachial artery FMD analysis (2 minutes of cuff occlusion and 5 minutes of reperfusion) was measured in HF patients on intravenous inotropic support (n = 9) awaiting cardiac transplantation. Unilateral, upper-body resistance exercises (moderate intensity, combination of isometric and isotonic exercises at 60%-80% of maximum) were performed 3 d/wk for 4 weeks. Follow-up FMD analysis was conducted after training. Central hemodynamics were defined via right-side-heart catheterization.

Results: At baseline prior to training, HF patients elicited a significant hyperemic response 10 seconds following cuff occlusion (mean increase in blood flow: 194 ± 44 mL/min, P < .05). Despite this significant hyperemic response, HF patients demonstrated a mild, but paradoxical vasoconstriction of nearly 3% at 1-minute after cuff release. Four weeks of resistance training corrected the paradoxical vasoconstriction observed at baseline and resulted in vasodilatation (a positive increase in brachial artery diameter of 0.04 ± 0.04 mm, at 1 minute after cuff release; P < .05). Conversely, in a subset of 3 HF patients, studies in the untrained contralateral arm revealed no change in the FMD response.

Conclusion: Moderate-intensity upper-body resistance training improved brachial artery FMD in end-stage HF patients on inotropic support. The reversal of the paradoxical vasoconstrictive response to reactive hyperemia following 4 weeks of training may be secondary to local improvements in vascular endothelial function rather than a quantitative change in the reactive hyperemic stimulus.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Cardiotonic Agents / administration & dosage
  • Chronic Disease
  • Combined Modality Therapy
  • Endothelium, Vascular
  • Female
  • Heart Failure / complications
  • Heart Failure / rehabilitation*
  • Heart Transplantation
  • Hemodynamics
  • Humans
  • Male
  • Middle Aged
  • Peripheral Vascular Diseases / complications
  • Peripheral Vascular Diseases / rehabilitation*
  • Resistance Training*
  • Vasodilation*

Substances

  • Cardiotonic Agents