Safety and efficiency of supervised aerobic exercise training, using cardiovascular machines, for patients with terminal heart failure, included in heart transplant waiting list

Abstract

Purpose of research is to assess safety and efficiency of controlled aerobic training for patients with terminal heart failure (HF) and to develop methodology of interval training using treadmill and cycle for HF patients, included in heart transplant waiting list (HTWL). Nineteen males with terminal HF, included in HTWL, aged 22–64, with left ventricular ejection fraction 11–33% were assessed. Initially, 6-minute walk (6MW) and cardiopulmonary test (CPT) were performed, and the type of aerobic training was selected in accordance to individual cardiorespiratory fitness level and personal cardiovascular machine preference. Study group included HF patients with stable hemodynamic data, without inotropic therapy, with 6MW distance from 100 to 427 m, and CPT results from 5.4 to 13.4 mL/kg/min. All patients participated in long-term (2–12 months) 4–5 days a week interval training. The duration of training session was 6–30 min according to patient's individual working capacity and subjective condition. Heart rate reserve for study group was calculated: HRR = (190-age)-HRrest, and the HRtraining was determined as 30–40% of HRR. Training speed (V) on treadmill = 50% of V (6MW-test) km/hour. After 2–12 months of training sessions, all patients demonstrated increase: training duration from 13.1 min at baseline to 25 min (av. 11.9 ± 0.4 min) Р < 0.05; treadmill walking distance from 356 m at baseline to 742 m (av. 386 ± 16 m) Р < 0.01; treadmill walking speed from 1.58 km/hour at baseline to 2.37 km/hour (av. 0.78 ± 0.01 km/hour) Р < 0.001. The number of training sessions was associated with growth of treadmill walking distance ( r = 0.38) and overall session duration ( r = 0.6). All patients well-tolerated individualized physical training sessions with intensity regulated by the proposed formula. No complications were registered. In total, 77.7% of patients self-selected cardiovascular machine: 42.1% preferred treadmill, but 31.6% used both treadmill and cycle. Controlled training, using cardiovascular machines, are safe, well-tolerated and effective for patients with terminal HF, included in HTWL, in case of self-selection of the machine and individualised training intensity level.