Strength/endurance training versus endurance training in congestive heart failure

The aim of this study was to compare the effects of endurance training alone (ET) with combined endurance and strength training (CT) on hemodynamic and strength parameters in patients with congestive heart failure (CHF). Twenty male patients with CHF were randomized into one of two training regimens consisting of endurance training or a combination of endurance and resistance training. Group ET had 40-min interval cycle ergometer endurance training three times per week. Group CT combined endurance and strength training with the same interval endurance training for 20 min, followed by 20 min of strength training. Left ventricular function was assessed at baseline and after 40 training sessions by echocardiography and radionuclide ventriculography. Work capacity was measured with cardiopulmonary exercise test (CPX) and lactate determination. Strength was measured with an isokinetic dynamometer. After 40 sessions, the ET group improved functional class, work capacity, peak torque, and muscular endurance. However, peak O2 remained unchanged. Left ventricular ejection fraction (LVEF) and fractional shortening (FS) decreased, whereas left ventricular end-diastolic diameter (LVED) increased. The CT group improved NYHA score, working capacity, peak O2, and peak lactate; peak torque and muscular endurance, LVEF, and FS increased, whereas LVED decreased. Compared with ET, CT was significantly (P < 0.05) better in improving LV function. Combined endurance/strength training was superior to endurance training alone concerning improvement of LV function, peak VO2, and strength parameters. It appears that for stable CHF patients, a greater benefit can be derived from this training modality.