Review of the Effects of Resistance Training in Patients with Chronic Heart Failure: Potential Effects Upon the Muscle Hypothesis

Abstract

Resistance training (RT) has been proposed as a potential management technique for persons with congestive heart failure (CHF) with the possibility of improving the vicious CHF cycle of pump failure, neuroendocrine abnormalities, skeletal muscle myopathies, dyspnea, fatigue, increased ventilation, and increased sympathetic nervous system activity (the Muscle Hypothesis of CHF). However, very little research has examined the effects of RT in persons with CHF or the effects of RT on the Muscle Hypothesis. The purposes of this paper are to describe the long-term effects of RT in persons with CHF and attempt to describe how these effects will impact the Muscle Hypothesis of CHF. A Medline search of English articles on RT in CHF was performed with the following keywords: resistance training, strength training, weight training, resistance exercise, heart failure, and muscle hypothesis. The references of published articles were further reviewed for additional articles pertaining to RT in CHF and the potential effects on the Muscle Hypothesis. Inclusion criteria for this review were studies of RT alone or RT with aerobic exercise (AE) in persons with CHF. Three review articles and 24 studies of RT were found of which 6 studies examined RT alone, 7 studies examined RT with short bouts of AE (< 5 minutes of continuous AE), and 11 studies examined the effects of RT combined with long bouts of AE. The results of these studies revealed significant improvements in muscle strength and endurance, peak oxygen consumption, forearm blood flow, left ventricular function, and quality of life with very few complications from RT. Differences in the methods of RT were found which likely affected the observed results. Chronic RT alone or with AE appears to favorably influence many aspects of the muscle hypothesis of chronic CHF. The improvements in skeletal muscle strength and endurance, peak oxygen consumption, forearm blood flow, left ventricular function, and quality of life in persons with CHF suggest that RT prescribed alone or with AE can be done safely and has favorable effects on the CHF Muscle Hypothesis. Further examination of isolated RT and RT with short versus long bouts of AE is needed.