Acute Cardiovascular Response to Resistance Training During Cardiac Rehabilitation: Effect of Muscles Mass Used in Patients With Chronic Heart Failure

Gillet A.1, Lamotte M.1, van de Borne P.21Erasmus Hospital and Free University of Brussels, Physiotherapy, Brussels, Belgium, 2Erasmus Hospital and Free University of Brussels, Cardiology, Brussels, BelgiumBackground: Cardiac rehabilitation (CR) induces a benefit in terms of morbidity and mortality. Resistance training has been introduced in CR to give more benefit than traditional endurance training. The physiotherapist must ensure to offer the best treatment while being safe.Purpose: The purpose of this work is to compare the hemodynamic impact of restive training on the leg press depending on the muscle mass used in patients with chronic heart failure. Studies performed on hemodynamic impact concluded there is a cardiovascular risk in performing isometric exercises for patients with chronic heart failure. Only few studies using a similar methodology to ours were conducted and these do not address the importance of muscle mass used during this type of exercise. Exercise capacity variable are obtained during a maximal cardiopulmonary exercise testing (CPET).Methods: Twenty-tree men with left ventricular dysfunction after a myocardial infarction or coronary artery bypass graft surgery were to an exercise resistive training (mean age 6 SD 61 years, mean ejection fraction [EF] 29 7%, n 23) VO2p 19 +/- 5 ml/Kg.min slope VE/Vco2: 36. Our methodology includes a dynamic resistive training exercise of high intensity (75% -1 Maximum Voluntary Contraction) on the leg press, fast execution, 3 sets of 10 repetitions with one minute of recovery. We proposed two methods performed by the same individual, one on one leg, another one on two legs. The order is randomized. A Task Force Monitor (TFM) noninvasive measurement system was used for continuous monitoring of the heart rate (HR), blood pressure (BP) and stroke volume (SV). We then compare the results of both methods with each other.Results: The results of our study showed statistically significant higher heart rate parameters, blood pressure and cardiac output during the exercise to the leg press with both legs compared to with one leg. We did not find significant difference in peripheral vascular resistance. We can explain this by the stronger activation of mechanical and metabolic receptors at peripheral levels during an exercise with both legs. Moreover, in each modality, we observed a parameter increase in the 3rd sets compared to the first. We noted an increase in cardiac output as well as a reasonable increase in systolic blood pressure which shows that the exercise on two legs is not harmful for the cardiovascular system. We even found a more significant increase in systolic blood pressure at the end of a cardio pulmonary exercise testing compared to the 3rd series on both legs.Conclusion(s): We can conclude to an increase in the hemodynamic response during a muscle resistive training to leg press on both legs compared to the same exercise on one leg.Implications: In a nutshell, the results did not show any contraindication for this type of exercise with both legs in patients with chronic heart failure.Funding acknowledgements: NonTopic: CardiorespiratoryEthics approval: Approval by committe ethics of Hopital ErasmeAll authors, affiliations and abstracts have been published as submitted.