High-Intensity Training Improves Global and Segmental Strains in Severe Congestive Heart Failure

Background: High-intensity training (HIT) is superior to moderate aerobic training (MAT) for improving quality of life in congestive heart failure (CHF) patients. Speckle-tracking echocardiography (STE) has recently been suggested for estimation of left ventricle global and regional function. We evaluated the utility of STE for characterizing differences in cardiac function following MAT or HIT in a CHF rat model. Methods and Results: After baseline physiologic assessment, CHF was induced by means of coronary artery ligation in Sprague-Dawley rats. Repeated measurements confirmed the presence of CHF (ejection fraction 52 +/- 10%, global circumferential strain (GCS) 10.5 +/- 4, and maximal oxygen uptake (VO2max) 71 11 mL center dot min(-l)center dot kg(-1); P <.001 vs baseline for all). Subsequently, rats were divided into training protocols: sedentary (SED), MAT, or HIT. After the training period, rats underwent the same measurements and were killed. Training intensity improved V-02max (73 +/- 13 mL center dot min(-1)center dot kg(-1) in MAT [P <.01 vs baseline] and 82 +/- 6 mL center dot min(-l)center dot kg(-1) in HIT [P <.05 vs baseline or SED] and ejection fraction (50 21% in MAT [P <.001 vs baseline] and 66 +/- 7% in HIT [P >.05 vs baseline]). In addition, strains of specific segments adjacent to the infarct zone regained basal values (P >.05 vs baseline), whereas global cardiac functional parameters as assessed with the use of 2-dimensional echocardiography did not improve. Conclusions: High-intensity exercise training improved function in myocardial segments remote from the scar, which resulted in compensatory cardiac remodeling. This effect is prominent, yet it could be detected only with the use of STE. (J Cardiac Fail 2017;23:392-402)