Key result
Eccentric resistance exercise boosts peak atrial contractile strain up to ~28% in HFmrEF.
Why the study?
The study aimed to assess acute changes in atrial function following single bouts of eccentric resistance exercise performed at two different loads.
Does single-bout eccentric resistance exercise improve acute left atrial function parameters in patients with HFmrEF?
RCT (n=25)
Single-blind (sonographer blinded to experimental session)
randomized order through computer software
No
Does single-bout eccentric resistance exercise improve acute left atrial function parameters in patients with HFmrEF?
Effect estimate: Increased by 28.4% after ECC-50 and 17.0% after ECC-20
p-value: p=0.034
Single sessions of eccentric resistance exercise safely mobilize left atrial functional reserve and increase cardiac output in HFmrEF patients, despite a mild rise in LV filling pressure.
Supports eccentric resistance exercise for acute LA reserve in HFmrEF; extends load-dependent exercise effects on atrial function in heart failure.
In this study, we aimed to assess acute changes occurring on atrial function following single bouts of eccentric resistance exercise (ECC-RE) performed at two different loads. Twenty-five patients with chronic heart failure with middle range ejection fraction (HFmrEF) participated in three experimental sessions in a randomized order and on separate days: two sessions of ECC RE at 20% (ECC-20) of one-repetition maximum (1-RM) and 50% (ECC-50) 1-RM, and one session of control, without exercise. Each session lasted three minutes. Before and immediately after the sessions, patients underwent echocardiography and blood pressure and heart rate measurement. Peak atrial longitudinal strain (PALS) and peak atrial contractile strain (PACS) significantly increased after both ECC-20 (+16.3%) and ECC-50 (+18.1%) compared to control (between sessions p = 0.022). Peak atrial contractile strain (PACS) significantly increased after ECC-50 (+28.4%) compared to ECC-20 (+17.0%) and control (between sessions p = 0.034). The ratio of transmitral and annular velocities (E/E’) increased significantly after ECC-20 (+10.4%) and ECC-50 (+19.0%) compared to control (between groups p = 0.003). EF, left ventricular longitudinal strain, and stroke volume did not change after ECC-RE sessions compared to control. Cardiac output increased significantly after ECC-20 and ECC-50 compared to control, (between groups p = 0.025). In conclusion, both ECC-RE sessions were well tolerated, and LA functional reserve was properly mobilized in response to ECC-RE in patients with HFmrEF. Cardiac output increased at the cost of an increased LV filling pressure, but no detrimental changes of LV function occurred.
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Caminiti et al. (2022) conducted an RCT in Heart failure with middle range ejection fraction (HFmrEF) (n=25). Eccentric resistance exercise (ECC-RE) at 20% and 50% of 1-repetition maximum vs. Control session (3 minutes of rest without exercise) was evaluated on Peak atrial contractile strain (PACS) (Increased by 28.4% after ECC-50 and 17.0% after ECC-20, p=0.034). Eccentric resistance exercise significantly increased peak atrial contractile strain compared to control in patients with HFmrEF, with a greater increase following higher load exercise.
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