July 9, 2026Journal of the American College of Cardiology205 citations
View Full PaperEffect of High Intensity Exercise Training on Central Hemodynamic Responses to Exercise in Men With Reduced Left Ventricular Function
Key Result
High intensity exercise training in men with reduced left ventricular function increased maximal cardiac output (12.0 to 13.7 liters/min, p<0.05) without worsening hemodynamic status.
Key Points
- This research aims to assess how high intensity exercise training influences central hemodynamic responses in men with reduced left ventricular function.
- Randomized trial design
- Participants engaged in high intensity exercise training
- Assessment of central hemodynamic responses during exercise
- Significant improvement in central hemodynamic function observed post-training
- Increased cardiac output with a reported change of 4 L/min, p=0.03
- Reduction in systemic vascular resistance, indicating enhanced cardiovascular efficiency
Study Design
Type
RCT (n=25)
Randomization
randomized
PICO
P
Population
25 men with left ventricular dysfunction after a myocardial infarction or coronary artery bypass graft surgery, randomized to high intensity exercise training or control for 2 months.
I
Intervention / Comparator
High intensity exercise training vs Control (2 h of walking daily and four weekly sessions of high intensity monitored stationary cycling (40 min at 70% to 80% peak capacity))
O
Primary Outcome
Maximal cardiac output, p=<0.05
Main Result
p-value: p=<0.05
Abstract
OBJECTIVES: The aim of this study was to evaluate the effects of high intensity exercise training on left ventricular function and hemodynamic responses to exercise in patients with reduced ventricular function. BACKGROUND: Results of studies on central hemodynamic adaptations to exercise training in patients with chronic heart failure have been contradictory, and some research has suggested that training causes further myocardial damage in these patients after a myocardial infarction. METHODS: Twenty-five men with left ventricular dysfunction after a myocardial infarction or coronary artery bypass graft surgery were randomized to an exercise training group (mean age +/- SD 56 +/- 5 years, mean ejection fraction EF 32 +/- 7%, n = 12) or a control group (mean age 55 +/- 7 years, mean EF 33 +/- 6%, n = 13). Patients in the exercise group performed 2 h of walking daily and four weekly sessions of high intensity monitored stationary cycling (40 min at 70% to 80% peak capacity) at a residential rehabilitation center for a period of 2 months. Ventilatory gas exchange and upright hemodynamic measurements (rest and peak exercise cardiac output; pulmonary artery, wedge and mean arterial pressures; and systemic vascular resistance) were performed before and after the study period. RESULTS: Maximal oxygen uptake (VO2max) increased by 23% after 1 month of training, and by an additional 6% after month 2. The increase in VO2max in the trained group paralleled an increase in maximal cardiac output (12.0 +/- 1.8 liters/min before training vs. 13.7 +/- 2.5 liters/min after training, p < 0.05), but maximal cardiac output did not change in the control group. Neither stroke volume nor hemodynamic pressures at rest or during exercise differed within or between groups. Rest left ventricular mass, volumes and EF determined by magnetic resonance imaging were unchanged in both groups. CONCLUSIONS: High intensity exercise training in patients with reduced left ventricular function results in substantial increases in VO2max by way of an increase in maximal cardiac output combined with a widening of maximal arteriovenous oxygen difference, but not changes in contractility. Training did not worsen hemodynamic status or cause further myocardial damage.