Cardiac hemodynamics and individual responses to exercise training in patients with coronary heart disease

Abstract

In patients with coronary heart disease (CHD), individualized training programs are strongly recommended to optimize peak oxygen uptake (VO2peak) improvement and prognosis. However, cardiac hemodynamics factors responsible for a positive response to training remain unclear. The aim of this study was to compare cardiac hemodynamics changes after an exercise training program in responders (R) versus non-responders (NR) CHD patients. The training response status was defined as the median change in VO2peak. A total of 72 CHD patients (78% males, 63 ± 9years) were recruited to perform an exercise training program (interval, continuous or both) for 3 months, 2 to 3 times per week. Patients underwent a cardiopulmonary exercise testing (CPET) on a cycle ergometer (10 to 15 W/min) before and after training, with VO2peak assessment. Cardiac hemodynamics (e.g., cardiac output (CO), cardiac index (CI), stroke volume (SV), systemic vascular resistance (SVR)) was measured by impedance cardiography during the CPET before and after training. In the R group, VO2peak (+16.8%, P < 0.001), CO, CI and SV increased by 16.6%, 16.8% and 13.0%, respectively (P < 0.01) after the training program. In the NR group, VO2peak, CO, CI and SV increased by 0.48%, 5.12%, 8.07% and 5.75%, respectively (P < 0.01). The SVR decreased in both groups (–19.0% in R and –11.4% in NR, P < 0.001) (graph – Fig. 1). The R group of CHD patients showed better improvement in cardiac hemodynamics and CPET parameters after a 12-week training program than NR. Further studies are needed to determine the best way to individualize training programs for non-responder cardiac patients.