Is strength training the more efficient training modality in chronic heart failure?

Purpose: An open, randomized, controlled study was designed to study the effects of exclusive strength training (ST) in patients with severe chronic heart failure (CHF) in comparison with conventional endurance (ET) and combined ET-ST training (CT). The hypothesis was that ST would at least be equal to ET or CT, because peripheral muscle atrophy and weakness play a key role in exercise limitation in CHF patients. Methods: Three groups of 15 patients underwent ST, ET, or CT during 40 sessions, three times a week, for 45 min. Fifteen patients served as control group. Before and after intervention, left ventricular ejection fraction (LVEF), peak oxygen consumption (VO2peak), peak workload, thigh muscle volume, knee extensor strength, endurance, and quality of life (QoL) were assessed. Results: All measured parameters improved significantly in the three training groups, except for knee extensor strength in ET. Training outcome was superior in all three training groups compared with the control group, but statistical significance was only reached for VO2peak and peak workload, thigh muscle volume, and knee extensor endurance. In contrast, knee extensor strength, LVEF, and QoL did not reach statistical significance. None of the training modalities proved to be superior to any other, although small differences between the three groups were observed. Conclusion: Independently of the training modality, intensive exercise training is efficient in increasing cardiac function, exercise capacity, peripheral muscle function, and QoL in CHF patients.