Safety and efficacy of exercise for individuals with CHF

Swank, Ann

Abstract

Congestive heart failure is a chronic form of heart disease characterized by ventricular dysfunction and exercise intolerance. Nearly five million Americans have CHF and over 400,000 new cases are diagnosed each year. Interventions such as exercise training that have the potential to limit hospital re-admissions and subsequent costly procedures will be important for cost effective disease management. The safety and effectiveness of combined strength training (ST) and aerobic exercise regimens for the individual with CHF has not been determined. Combining exercise modalities will optimize exercise outcomes. This proposal will provide preliminary data regarding the safety and effectiveness of combining strength training (ST) with aerobic exercise training for individuals with CHF. This project will use a randomized, controlled design with subjects randomly assigned to one of three experimental training groups: (1) aerobic exercise training alone (AT), (2) AT with low intensity strength training and (3) AT with high intensity strength training. Indices of ventricular function including ventricular volumes/pressures and geometry during a standardized ST exercise protocol will be measured using echocardiography to assess safety of ST. We hypothesize that adding ST to aerobic exercise will result in a similar stress to ventricular function as aerobic exercise alone indicating that combining exercise modalities may be safe for individuals with CHF. The effectiveness of adding ST to aerobic exercise will be measured through changes in muscular strength as measured by the 1-repetition maximum and quality of life changes as determined by questionnaire. Previous work from our lab indicates an average strength increase of 26 percent for a combined high intensity ST (80 percent maximal strength) and aerobic exercise program among individuals with CHF. It is hypothesized that strength gains in this investigation will be similar.