Effects of the exercise training on skeletal muscle oxygen consumption in heart failure patients with reduced ejection fraction

Author(s)

Guimaraes, Guilherme Veiga ^[1] ; Ribeiro, Fernando ^{[2, 3]} ; Castro, Rafael Ertner ^[1] ; Roque, Jean Marcelo ^[1] ; Teixeira Machado, Alexander Douglas ^[1] ; Antunes-Correa, Ligia M. ^[1] ; Ferreira, Silvia Ayub ^[1] ; Bocchi, Edimar Alcides ^[1]

Affiliation

^[1] Univ Sao Paulo, Sch Med, Heart Inst, Av Dr Eneas de Carvalho Aguiar 44, BR-05403000 Sao Paulo, SP - Brazil

^[2] Univ Aveiro, Sch Hlth Sci, Aveiro - Portugal

^[3] Univ Aveiro, Inst Biomed iBiMED, Aveiro - Portugal

• Document type: Journal article
• Source: INTERNATIONAL JOURNAL OF CARDIOLOGY; v. 343, NOV 15 2021.
• Web of Science Citations: 0

Abstract

Aims: Skeletal muscle dysfunction is a systemic consequence of heart failure (HF) that correlates with functional capacity. However, the impairment within the skeletal muscle is not well established. We investigated the effect of exercise training on peripheral muscular performance and oxygenation in HF patients. Methods and results: HF patients with ejection fraction <= 40% were randomized 2:1 to exercise training or control for 12 weeks. Muscle tissue oxygen was measured noninvasively by near-infrared spectroscopy (NIPS) during rest and a symptom-limited cardiopulmonary exercise test (CPET) before and after intervention. Measurements included skeletal muscle oxygenated hemoglobin concentration, deoxygenated hemoglobin concentration, total hemoglobin concentration, VO2 peak, VE/VCO2 slope, and heart rate. Muscle sympathetic nerve activity by microneurography, and muscle blood flow by plethysmography were also assessed at rest pre and post 12 weeks. Twenty-four participants (47.5 +/- 7.4 years, 58% men, 75% no ischemic) were allocated to exercise training (ET, n = 16) or control (CG, n = 8). At baseline, no differences between groups were found. Exercise improved VO2 peak, slope VE/VCO2, and heart rate. After the intervention, significant improvements at rest were seen in the ET group in muscle sympathetic nerve activity and muscle blood flow. Concomitantly, a significant decreased in Oxy-Hb (from 29.4 +/- 20.4 to 15.7 +/- 9.0 mu mol, p = 0.01), Deoxi-Hb (from 16.3 +/- 8.2 to 12.2 +/- 6.0 mu mol, p = 0.003) and HbT (from 45.7 +/- 27.6 to 27.7 +/- 13.4 mu mol, p = 0.008) was detected at peak exercise after training. No changes were observed in the control group. Conclusion: Exercise training improves skeletal muscle function and functional capacity in HF patients with reduced ejection fraction. This improvement was associated with increased oxygenation of the peripheral muscles, increased muscle blood flow, and decreased sympathetic nerve activity. (AU)

• FAPESP's process: 10/08990-1 - Effect of interval versus continuous training on function sympathetic and peripheral infusion in patients with heart failure: a randomized study with control groups
• Grantee: Guilherme Veiga Guimarães
• Support Opportunities: Regular Research Grants