Vinicius Z Maldaner da Silva1, Alexandra Lima, Graziella B Cipriano, Marianne Lucena da Silva, Filippe V Campos, Ross Arena, Wagner Rodrigues Martins, Gaspar Chiappa, Martim Bottaro, Gerson Cipriano. 1. Division of Physical Therapy and Health Sciences and Technologies (Messrs da Silva and Campos; Drs Lima, G. B. Cipriano, Martins; and G. Cipriano, and Ms da Silva) and Physical Education College (Dr Bottaro), University of Brasilia, Brasilia, Brazil); Ergometry and Sports Medicine Department, Heart Institute of Distrito Federal, Brasilia, Brazil (Mr da Silva and Dr Lima); Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago (Dr Arena); and Laboratory of Exercise Physiopathology, Department of Cardiology, Hospital de Clínicas, Porto Alegre, RS, Brazil (Dr Chiappa).
Abstract
PURPOSE:Noninvasive ventilation may improve cardiovascular function and exercise performance. We evaluated the physiologic impact of noninvasive ventilation during isokinetic knee extension resistance exercise in patients with heart failure. METHODS: This clinical trial included 10 male compensated patients with ischemic heart failure (age, 57 ± 9.1 years; ejection fraction, 28.5 ± 5.8%). Subjects underwent 2 bouts of exercise on an isokinetic dynamometer, separated by 72 hours of rest. The resistance exercise was concentric knee extension, at a speed of 60°/s. Five sets of 10 repetitions were performed during the 2 exercise bouts, and each set was separated by 2 minutes of rest. Subjects were administered either bilevel positive airway pressure ventilation (BV) or sham ventilation 20 minutes before and during the 2 exercise sessions in a randomized fashion. Heart rate, systolic blood pressure, and diastolic blood pressure were measured at rest, during exercise, and into recovery. Changes in peak torque (ΔPT), total work (ΔTW), and power (ΔPw) between the fifth and first sets were also measured. RESULTS: Compared with the sham intervention, BV significantly decreased heart rate, systolic blood pressure, and diastolic blood pressure at rest and during exercise (P < .01). There were no significant differences in these variables during recovery. Bi-level positive airway pressure ventilation also significantly reduced ΔPT, ΔTW, and ΔPw compared with the sham intervention (P < .01). CONCLUSIONS:Bi-level positive airway pressure ventilation significantly improved the cardiovascular response and fatigability during resistance exercise in patients with heart failure. These results suggest that use of BV during exercise training may be beneficial in this population with chronic disease.
RCT Entities:
PURPOSE: Noninvasive ventilation may improve cardiovascular function and exercise performance. We evaluated the physiologic impact of noninvasive ventilation during isokinetic knee extension resistance exercise in patients with heart failure. METHODS: This clinical trial included 10 male compensated patients with ischemic heart failure (age, 57 ± 9.1 years; ejection fraction, 28.5 ± 5.8%). Subjects underwent 2 bouts of exercise on an isokinetic dynamometer, separated by 72 hours of rest. The resistance exercise was concentric knee extension, at a speed of 60°/s. Five sets of 10 repetitions were performed during the 2 exercise bouts, and each set was separated by 2 minutes of rest. Subjects were administered either bilevel positive airway pressure ventilation (BV) or sham ventilation 20 minutes before and during the 2 exercise sessions in a randomized fashion. Heart rate, systolic blood pressure, and diastolic blood pressure were measured at rest, during exercise, and into recovery. Changes in peak torque (ΔPT), total work (ΔTW), and power (ΔPw) between the fifth and first sets were also measured. RESULTS: Compared with the sham intervention, BV significantly decreased heart rate, systolic blood pressure, and diastolic blood pressure at rest and during exercise (P < .01). There were no significant differences in these variables during recovery. Bi-level positive airway pressure ventilation also significantly reduced ΔPT, ΔTW, and ΔPw compared with the sham intervention (P < .01). CONCLUSIONS: Bi-level positive airway pressure ventilation significantly improved the cardiovascular response and fatigability during resistance exercise in patients with heart failure. These results suggest that use of BV during exercise training may be beneficial in this population with chronic disease.