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* From the Cardiology Divisions (Drs. Wagner and Dubach), Kantonsspital Chur, Basel, Switzerland; University Hospital(Dr. Schwitter), Zurich, Switzerland; the University of Genoa (Dr. Gianrossi), Genoa, Italy; and Palo Alto Veterans Affairs Medical Center and Stanford University (Dr. Myers), Palo Alto, CA.
Correspondence to: Jonathan Myers, PhD, Palo Alto Veterans Affairs Health Care System, Cardiology 111C, 3801 Miranda Ave, Palo Alto, CA 94304; e-mail: DRJ993{at}aol.com
Background: The time required for oxygen uptake
(
O2) to return to baseline level
(recovery kinetics) is prolonged in patients with reduced ventricular
function, and the degree to which it is prolonged is related to the
severity of heart failure, markers of abnormal ventilation, and
prognosis. In the present study, we sought to determine the effect of
exercise training on O2 recovery
kinetics in patients with reduced ventricular function.
Methods: Twenty-four male patients with reduced ventricular
function after a myocardial infarction were randomized to either a
2-month high-intensity residential exercise training program or to a
control group. O2 kinetics in recovery
from maximal exercise were calculated before and after the study period
and expressed as the slope of a single exponential relation between
O2 and time during the first 3 min of
recovery.
Results: Peak
O2 increased significantly in the
exercise group (19.4 ± 3.0 mL/kg/min vs 25.1 ± 4.7 mL/kg/min,
p < 0.05), whereas no change was observed in control subjects. The
O2 half-time in recovery was reduced
slightly after the study period in both groups (108.7 ± 33.1 to
102.1 ± 50.5 s in the exercise group and 122.3 ± 68.7 to
107.5 ± 36.0 s in the control group); neither the change within or
between groups was significant. The degree to which
O2 was prolonged in recovery was
inversely related to measures of exercise capacity (peak
O2, watts achieved, and exercise time;
r = - 0.48 to - 0.57; p < 0.01) and directly
related to the peak ventilatory equivalents for oxygen
(r = 0.59, p < 0.01) and carbon dioxide
(r = 0.57, p < 0.01).
Conclusion: Two months of high-intensity training did
not result in a faster recovery of O2 in
patients with reduced ventricular function. This suggests that
adaptations to exercise training manifest themselves only during, but
not in, recovery from exercise.
Key Words: chronic heart failure • exercise training • oxygen uptake
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