RESISTANCE TRAINING IN ELDERLY HEART FAILURE PATIENTS

Wake Forest University Health Sciences, Winston-Salem NC

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Abstract

DESCRIPTION (provided by applicant): Congestive heart failure (CHF) affects nearly 5 million Americans, most of who are older than 65 years of age. In addition to the substantial morbidity and mortality associated with this condition, CHF generally results in a decline in physical function and health-related quality of life (HRQOL). Reduced cardiac function leads to a number of pathophysiologic responses that include neurohormonal activation, pulmonary dysfunction, and vascular abnormalities. The potential for aerobic exercise training to reverse/improve many of these compensatory responses has been well documented in younger, and to a lesser extent, in older CHF patients. Of special interest are recent studies that have observed atrophy of skeletal muscle fibers and muscle loss (collectively known as sarcopenia)in CHF patients, a response that appears to be secondary to hypoperfusion and the reduced supply of blood nutrients to this tissue. Skeletal muscle loss appears to occur in both type I and type II fibers of CHF patients. This is of particular concern, and is of significant consequence, to the elderly CHF patient, given that the aging process alone results in atrophy of skeletal muscle fibers, particularly the type II variety. While data on older healthy individuals clearly demonstrate that resistance exercise training can improve skeletal muscle function, physical performance, and HRQOL, little is known about the impact of resistance exercise training on older adults with CHF. The primary goals of this pilot study are: 1) to evaluate the safety, compliance, and feasibility of a 16 week resistance training program in 20 elderly CHF patients and 2) to obtain an estimate of the intervention effect size for use in planning a definitive randomized trial. For a projected larger trial, we would hypothesize that resistance exercise training improves muscle strength through changes in skeletal muscle morphology and biochemistry. Secondary aims of this pilot are to determine the effects of the resistance training intervention on physical function, HRQOL, self-reported disability, skeletal muscle morphology/biochemistry, muscular strength, and HRQOL, in order to determine variances and effect sizes for sample size calculations for a randomized trial.