The effects of exercise training on the kinetics of oxygen uptake in patients with chronic heart failure

Roditis, Petros; Dimopoulos, Stavros; Sakellariou, Dimitrios; Sarafoglou, S.; Kaldara, Elisavet; Venetsanakos, J.; Vogiatzis, J.; Anastasiou-Nana, Maria; Roussos, Charis; Nanas, Serafim

doi:10.1097/hjr.0b013e32808621a3

Cited by 61 publications

(53 citation statements)

References 37 publications

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“…This is an important advantage as compared to O 2 onset kinetics, which requires averaging of multiple exercise tests to obtain a reliable assessment in CHF patients (Roditis et al 2007;Kemps et al 2007). Moreover, the determination of s-rec is objective and can be easily integrated in the software of commercially available breath-bybreath respiratory systems.…”

Section: O 2 Recovery Kineticsmentioning

confidence: 99%

“…Other variables that are potentially useful for the assessment of training effects include the rates of changes of _ VO 2 during or after a submaximal constant-load test (O 2 onset and recovery kinetics, respectively). Recently, Roditis et al (2007) reported an improvement in O 2 onset kinetics after physical training in CHF patients. A limitation of their approach, however, was that multiple exercise tests were required to obtain a sufficient signal to noise ratio.…”

Section: Introductionmentioning

confidence: 99%

“…Other effort-independent variables that can be obtained from a symptom-limited exercise test include the _ V E = _ VCO 2 slope (the slope of the linear relationship between minute ventilation and carbon dioxide output) and the oxygen uptake efficiency slope (OUES), representing the linear relationship between _ VO 2 and the logarithm of _ V E . Although it is well established that the _ V E = _ VCO 2 slope is a reproducible variable providing important prognostic information for CHF patients (Arena et al 2007), studies addressing its sensitivity to detect training effects showed conflicting results (Belardinelli et al 2006;Roditis et al 2007). Considering OUES, two recent studies in CHF patients reported significant improvements of this variable after training (Gademan et al 2008;Van Laethem et al 2007).…”

Section: Introductionmentioning

confidence: 99%

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Assessment of the effects of physical training in patients with chronic heart failure: the utility of effort-independent exercise variables

et al. 2009

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Traditionally, the effects of physical training in patients with chronic heart failure (CHF) are evaluated by changes in peak oxygen uptake (peak VO(2)). The assessment of peak VO(2), however, is highly dependent on the patients' motivation. The aim of the present study was to evaluate the clinical utility of effort-independent exercise variables for detecting training effects in CHF patients. In a prospective controlled trial, patients with stable CHF were allocated to an intervention group (N = 30), performing a 12-week combined cycle interval and muscle resistance training program, or a control group (N = 18) that was matched for age, gender, body composition and left ventricular ejection fraction. The following effort-independent exercise variables were evaluated: the ventilatory anaerobic threshold (VAT), oxygen uptake efficiency slope (OUES), the V(E)/VCO(2) slope and the time constant of VO(2) kinetics during recovery from submaximal constant-load exercise (tau-rec). In addition to post-training increases in peak VO(2) and peak V(E), the intervention group showed significant within and between-group improvements in VAT, OUES and tau-rec. There were no significant differences between relative improvements of the effort-independent exercise variables in the intervention group. In contrast with VAT, which could not be determined in 9% of the patients, OUES and tau-rec were determined successfully in all patients. Therefore, we conclude that OUES and tau-rec are useful in clinical practice for the assessment of training effects in CHF patients, especially in cases of poor subject effort during symptom-limited exercise testing or when patients are unable to reach a maximal exercise level.

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Section: O 2 Recovery Kineticsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Assessment of the effects of physical training in patients with chronic heart failure: the utility of effort-independent exercise variables

et al. 2009

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“…Naturally, concern is warranted for higher-risk patients because higher intensities are used with interval training. Nonetheless, interval training has now been used successfully in several clinical populations, including the elderly (> 75 years) and patients with peripheral artery disease, intermittent claudication, coronary artery disease, COPD, and T2D, without adverse medical side effects or complications [16,24,27,[33][34][35][36][37][38]. Although interval training may not be useful for all patients, the training model does present new alternatives for patients with metabolic complications.…”

Section: Discussionmentioning

confidence: 99%

The role of exercise interval training in treating cardiovascular disease risk factors

Earnest

2009

Curr Cardio Risk Rep

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Contemporary exercise guidelines focus on aerobic exercise conditioning that uses exercise intensities from 40% to 85% of maximal aerobic capacity for people who are at risk for cardiovascular disease. After a position statement from the American College of Sports Medicine challenged exercise practitioners to study exercise intensity, interval training began to emerge in the literature. Interval training involves having participants exercise briefl y at higher exercise intensities (90%-95% of maximum oxygen consumption) followed by a period of recovery. Although the net effect of interval training is aerobic, this style of training involves periodic excursions of exercise intensity into "anaerobic" metabolism and appears to better stimulate whole-body cardiorespiratory improvements as well as cellular signaling involved in metabolism and energy fl ux. Recent reports demonstrate that interval training is effective in the elderly and patients with peripheral artery disease, intermittent claudication, coronary artery disease, chronic obstructive pulmonary disease, and type 2 diabetes mellitus.

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“…In CHF, different methods have been used to determine these workloads, resulting in variations in the exercise dose. Some studies follow the traditional method of applying workloads of 100% VO 2peak work rate [11,12]. [6,13].…”

Section: Introductionmentioning

confidence: 99%

Limitations to High Intensity Exercise Prescription in Chronic Heart Failure Patients

Beale

Silberbauer

Lloyd

et al. 2011

European Journal of Cardiovascular Nursing

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Prescribing interval training from a standard test results in higher workloads than from a steep test in healthy individuals, but in CHF both methods prescribe similar workloads. However it should not be assumed that the two tests can be used interchangeably for CHF. This small-sized study raises issues about interval training prescription that may be hypothesis-generating for future larger-scale studies.

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The effects of exercise training on the kinetics of oxygen uptake in patients with chronic heart failure

Abstract: Exercise training improves O2 kinetics in chronic heart failure patients. Both continuous and interval training improve phase I O2-kinetics, but continuous training results in superior improvement of the phase II O2-kinetics, an indirect index of muscle oxidative capacity.

Cited by 61 publications

References 37 publications

Assessment of the effects of physical training in patients with chronic heart failure: the utility of effort-independent exercise variables

Assessment of the effects of physical training in patients with chronic heart failure: the utility of effort-independent exercise variables

The role of exercise interval training in treating cardiovascular disease risk factors

Limitations to High Intensity Exercise Prescription in Chronic Heart Failure Patients

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