This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. It is hypothesized that aortic stiffness will be abnormally elevated in HF patients, and will favorably respond to aerobic exercise training. An exercise-induced reduction in vessel stiffness leading to reduced left ventricular afterload may be a predominant mechanism by which a prognostic benefit is achieved in HF patients.
The specific aims of this proposal are: 1. To determine the effect of ten weeks of aerobic exercise training on AWV in patients with HF, 2. To examine whether patients with systolic and diastolic HF differ in terms of their baseline AWV or response to exercise training, 3. To assess the degree of improvement in aerobic capacity following training via cardiopulmonary exercise testing, 4. To investigate changes in resting cardiac function following training via echocardiography, 5. To examine alterations of inflammatory, neurohormonal and hormonal markers at the midpoint of and following training via blood analysis, 6. To assess changes in perceived quality of life following training using a validated instrument, 7. To study the relationships amongst baseline AWV, aerobic capacity, resting cardiac function, blood markers and quality of life, 8. To examine the relationships amongst improvements in these same variables following the ten-week aerobic training program and 9. To study, in a subgroup of 10 subjects, (5 with systolic HF and 5 with diastolic HF) changes in AWV, aerobic capacity, resting cardiac function, blood markers and quality of life measures 10 weeks after cessation of the supervised aerobic training program. Effect of Reduced Aortic Stiffness on Cardiac Function in Heart Failure The impact of exercise training on large vessel stiffness in the HF population has yet to be investigated. The potential for a significant reduction in large vessel stiffness following aerobic exercise training in the HF population is certainly plausible, based on previous research findings. Improved large vessel compliance is furthermore a likely mechanism by which a prognostic and functional benefit is realized in subjects with HF following exercise training as a result of the reduced afterload placed upon the heart. This reduction in cardiac work is considered a favorable adaptation with respect to long-term cardiac health.
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