Eccentric Cycling Amplifies Functional Capacity and Quality of Life in Heart Failure Patients: A Randomized Controlled Trial.
Lucy Bolam1 1The University of Western Australia, Crawley, Perth, W.A., Australia2Curtin University, Bentley, Perth, W.A., Australia3Fiona Stanley Hospital , Mudoch, Perth, W.A., Australia4Edith Cowan University, Joondalup, Perth, W.A. , Australia
Abstract
INTRODUCTION: Exercise training is recommended for patients with heart failure and reduced ejection fraction (HFrEF). Limited exercise capacity prevents patients from gaining optimal training benefit. Eccentric cycling (EC) is well tolerated in HFrEF enabling greater power output. We hypothesized that EC would result in superior functional outcomes than concentric cycle (CC).
METHODS: Thirty participants (7♀, 57±13 y; BMI 27±4 kg/m2) with HFrEF (ejection fraction 36±7%) were randomized in 1:1 superiority clinical trial to undertake EC (n = 16) or CC (n = 14). Interventions involved 14 weeks of training at matched intensity (40-80% of HR reserve), twice weekly. Peak oxygen consumption (V̇O2peak), 6-minute walk, functional lower extremity strength and health-related quality of life (Minnesota Living with Heart Failure, MLHF) were assessed.
RESULTS: Repeated measures ANOVA revealed time effect for V̇O2peak (P<0.001) with comparable improvement in each group (EC: 16.5±4.5 to 18.0±5.1 ml/kg/min, P=0.019; CC 18.6±6.1 to 20.6±6.4 ml/kg/min, P=0.008). Main effects were evident for 6-min walk (P<0.001) (EC: 465±86 to 521±83 m, P<0.001; CC 495±87 to 523±109 m, P=0.041, 30s sit-to-stand (P<0.001) (EC: 11±2 to 14±3 repetitions, P<0.001; CC 13±3 to 14±2 repetitions, P=0.082) and timed up-and-go (P=0.003) (EC: 7.1±1.3 to 6.1±1.0 s, P=0.008; CC 7.4±1.5 to 7.1±1.4 s, P=0.138). MLHF score improved greater (P=0.045) for EC (29±22 to 21±17) than CC (28±18 to 27±17).
CONCLUSION:EC conferred similar benefits in functional capacity as CC, with a superior effect on quality of life. EC is an efficacious approach for patients with HFrEF, who represent challenge in terms of exercise prescription.
This work was supported by WA Government FHRI Research Excellence Award (REA2022/1 Green) and the National Health and Medical Research Council (NHMRC, APP1085479).
Biography
Lucy Bolam is a senior exercise physiologist employed at Fiona Stanley Hospital and the University of Western Australia. Lucy is undertaking her PhD in cardiovascular rehabilitation with the Cardiovascular Research Group led by Danny Green and Louise Naylor at the University of Western Australia.