Effects of eccentric cycling training on aerobic and functional capacity in patients with heart failure: A randomised controlled trial.

OBJECTIVES

To evaluate the effects of eccentric and conventional concentric cycle training on aerobic and functional capacity and health-related quality of life in patients with heart failure.

DESIGN

Seventy participants (45 after attrition) with heart failure were randomised 1:1 to eccentric (n = 34) or concentric (n = 36) cycling and 45 completed the intervention (eccentric n = 25; concentric n = 20). Each intervention involved 2-weeks familiarisation and 12-weeks of training, performed at matched relative intensity (40-70% of heart rate reserve), twice weekly.

METHODS

The primary outcome was peak oxygen consumption (V̇O2peak); secondary outcomes included 6-minute walk distance, 30 s sit-to-stand, timed up-and-go, and the Minnesota Living with Heart Failure questionnaire to determine quality of life. Intention to treat analysis was conducted using linear mixed models.

RESULTS

The mean age of participants was 57 ± 13 years and 20% were female. The mean left ventricular ejection fraction was 31 ± 10%. Both interventions significantly enhanced V̇O2peak (eccentric: 17.7 ± 4.8 to 19.1 ± 5.2; concentric: 17.4 ± 6.0 to 19.8 ± 6.0 mL·kg-1·min-1, P = 0.002), 6-min walk distance (eccentric: 476 ± 77 to 547 ± 80; concentric: 485 ± 106 to 516 ± 113 m, P < 0.001), and 30 s sit-to-stand (eccentric: 12 ± 3 to 16 ± 3; concentric: 13 ± 4 to 14 ± 3 reps, P < 0.001). Timed up-and-go (eccentric: 7.2 ± 1.2 to 6.2 ± 1.1; concentric: 7.6 ± 1.5 to 7.3 ± 1.9 s, P < 0.001) and the Minnesota Living with Heart Failure questionnaire mental domain improved following eccentric, but not concentric cycling. Perceived exertion was lower during exercise training in eccentric cycling (P = 0.018).

CONCLUSIONS

Both eccentric cycling and concentric cycling improved aerobic capacity and functional outcomes in compromised patients with heart failure.