Article

Exercise training improves neurovascular control and functional
capacity in heart failure (HF) patients. However, the influence of the aetiology
on these benefits is unknown. We compared the effects of exercise training on
neurovascular control and functional capacity in idiopathic, ischaemic and
hypertensive HF patients.
Design Subjects consisted of 45 exercise-trained HF
patients from our database (2000-2015), aged 40-70 years old, functional class
II/III and ejection fraction </=40%, and they were divided into three groups:
idiopathic ( n = 11), ischaemic ( n = 18) and hypertensive ( n = 16). Methods
Functional capacity was determined by cardiopulmonary exercise testing. Muscle
sympathetic nerve activity (MSNA) was recorded by microneurography. Forearm blood
flow (FBF) was measured by venous occlusion plethysmography. Results Four months
of exercise training significantly reduced MSNA and significantly increased FBF
in all groups. However, the relative reduction in MSNA was greater in
hypertensive patients compared with that in idiopathic patients (frequency: -34%
vs . -15%, p = 0.01; incidence: -31% vs . -12%, p = 0.02). No differences were
found between hypertensive patients and ischaemic patients. The relative increase
in FBF was greater in hypertensive patients than in ischaemic and idiopathic
patients (42% vs. 15% and 17%, respectively, p = 0.02).
The relative increase in
forearm vascular conductance was greater in hypertensive patients compared with
those in ischaemic and idiopathic patients (57% vs . 13% and 26%, respectively, p
= 0.001). Exercise training significantly and similarly increased peak oxygen
consumption in all groups. Conclusion The exercise-induced improvement in
neurovascular control is more pronounced in hypertensive HF patients than in
idiopathic and ischaemic HF patients. The increase in functional capacity is
independent of aetiology.

Langue : ANGLAIS