Key result
High-load resistance exercise causes a ~4-point smaller heart rate increase vs. low-load in CAD.
Why the study?
Low-load resistance exercise is recommended in cardiac rehabilitation for coronary artery disease, but the safety and hemodynamic response to high-load resistance exercise remain unknown.
Does high-load resistance exercise improve hemodynamic response compared to low-load resistance exercise in patients with coronary artery disease?
RCT (n=43)
1:1 computer-generated randomization ratio into crossover sequence
No
Does high-load resistance exercise improve hemodynamic response compared to low-load resistance exercise in patients with coronary artery disease?
High-load resistance exercise is safe and elicits physiological hemodynamic responses similar to low-load resistance exercise in patients entering cardiac rehabilitation.
Answers are grounded in this paper and cite their sources.
Supports high-load resistance exercise in cardiac rehabilitation for coronary artery disease; confirms comparable hemodynamic safety to low-load protocols.
Low-load resistance exercise (LL-RE) is recommended as an adjunct therapy to aerobic exercise during cardiac rehabilitation in patients with coronary artery disease. The safety and hemodynamic response to high-load (HL) RE remain unknown. The aim of this study was to evaluate the hemodynamic response during both HL-RE and LL-RE prior to cardiac rehabilitation. Forty-three patients with coronary artery disease and/or percutaneous coronary intervention performed three sets of leg-press exercise using HL-RE (eight repetitions at the intensity of 80% of one repetition maximum (1-RM)) and LL-RE (16 repetitions at the intensity of 40% 1-RM) in a randomized crossover sequence. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and rating of perceived exertion were measured at baseline, after each set of RE and post-exercise. No clinically relevant changes in HR and BP or in patient-reported symptoms were recorded during HL-RE or LL-RE. Compared with baseline, HR and SBP increased during LL-RE (from 66 bpm to 86 bpm, time effect: p < 0.001; from 129 mmHg to 146 mmHg, time effect: p < 0.001) and HL-RE (from 68 bpm to 86 bpm, time effect: p < 0.001; from 130 mmHg to 146 mmHg, time effect: p < 0.001). Compared with HL-RE, the increase in HR was greater after the final set of LL-RE (32% vs. 28%, p = 0.015), without significant differences in SBP and DBP between LL-RE and HL-RE. Rating of perceived exertion was higher after the 1st set of HL-RE compared with LL-RE (median (interquartile range): 6 (5–7) vs. 6 (5–6), p = 0.010). In patients with coronary artery disease, both HL-RE and LL-RE were safe and well-tolerated. Hemodynamic changes were similar and within the physiological response to RE.
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Kambič et al. (2021) conducted an RCT in Coronary artery disease (n=43). High-load resistance exercise vs. Low-load resistance exercise (3 sets of 16 repetitions at 40% of 1-RM) was evaluated on Increase in heart rate after the final set of exercise (p=0.015). High-load resistance exercise was safe and well-tolerated, inducing a slightly smaller increase in heart rate after the final set compared to low-load resistance exercise in patients with coronary artery disease.
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