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European Journal of Heart Failure 2006 8(8):851-855; doi:10.1016/j.ejheart.2006.02.009
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© 2006 European Society of Cardiology

Effects of home-based exercise training on neurovascular control in patients with heart failure

Fábio Gazelato de Mello Francoa,*, Amilton C. Santosa, Maria Urbana P. Rondona, Ivani C. Trombettaa, Célia Strunza, Ana Maria W. Bragaa, Holly Middlekauffb, Carlos E. Negrãoa and Antônio C. Pereira Barrettoa

a Heart Institute (InCor), University of São Paulo Medical School São Paulo, Brazil
b Department of Cardiology, University of California Los Angeles, California

* Corresponding author. Tel.: +55 11 3069 5043. E-mail address: fabio.franco{at}incor.usp.br


  Abstract

Background: The effect of home-based exercise training on neurovascular control in heart failure patients is unknown.

Aims: To test the hypothesis that home-based training would maintain the reduction in muscle sympathetic nerve activity (MSNA) and forearm vascular resistance (FVR) acquired after supervised training.

Methods and results: Twenty-nine patients (54±1.9 years, EF<40%) were randomised into two groups: untrained control (n=12) and exercise trained (n=17). Both groups underwent assessment of Quality of Life (QoL), MSNA, and forearm blood flow. The exercise group underwent a 4-month supervised training program followed by 4 months of home-based training. After the initial 4 months of training, patients in the exercise group showed a significant increase in peak VO2 and reduction in MSNA, compared to the untrained group, but this was not maintained during 4 months of home-based training. In contrast, the decrease in FVR (56±3 vs. 46±4 vs. 40±2 U, p=0.008) and the improvement in QOL that were achieved during supervised training were maintained during home-based training.

Conclusions: Home-based training following supervised training is a safe strategy to maintain improvements in QoL and reduction in FVR in chronic heart failure patients, but is an inadequate strategy to maintain fitness as estimated by peak VO2 or reduction in neurohumoral activation.

Key Words: Heart failure • Cardiopulmonary • Exercise training

Received October 2, 2005; Revised January 2, 2006; Accepted February 13, 2006


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