The Impact of Exercise Training on Conduit Artery Wall Thickness and Remodeling in Chronic Heart Failure Patients

Exercise training is an important adjunct to medical therapy in chronic heart failure, but the extent to which exercise impacts on conduit artery remodeling is unknown. The aim of this study was to evaluate the impact of aerobic and resistance exercise training modalities on arterial remodeling in patients with chronic heart failure. We randomized 36 untrained subjects with chronic heart failure to resistance training (58.8 ± 3.5 years), aerobic training (61.3 ± 2.8 years), or an untrained control group (64.4 ± 2.4 years). Peak oxygen consumption during cycle ergometry increased after 12 weeks in both the resistance and aerobic training (P < 0.001) groups, but not in controls, whereas leg strength only increased after resistance training (P < 0.05). Brachial artery wall thickness decreased in the resistance training group (475 ± 10 versus 443 ± 13 μm; P < 0.01), whereas no changes were apparent in the aerobic or control groups. Brachial diameter increased by ≈6% and ≈5% in the aerobic training and resistance training groups (P < 0.01), with no change evident in the control group. The wall:lumen ratio consequently declined in the resistance training group at 12 weeks (0.121 ± 0.004 versus 0.107 ± 0.004; P < 0.01) and increased in the control group (0.111 ± 0.006 versus 0.121 ± 0.009; P < 0.05). No wall:lumen change was evident in the aerobic training group. Our findings suggest that exercise has a systemic impact on remodeling of conduit arteries in humans and that resistance exercise training may be advantageous in subjects with chronic heart failure in this regard.