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European Heart Journal 1996 17(7):1048-1055;
Copyright © 1996 by the European Society of Cardiology.
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© 1996 The European Society of Cardiology

High intensity knee extensor training, in patients with chronic heart failure

Major skeletal muscle improvement

G. Magnusson*,, A. Gordon{dagger}, L. Kaijser{ddagger}, C. Sylvén{dagger}, B. Isberg§, J. Karpakka and B. Saltin*

*Department of Physiology and Pharmacology, Karolinska Institute Stockholm, Sweden
{dagger}Department of Medicine Stockholm, Sweden
{ddagger}Department of Clinical Physiology Stockholm, Sweden
§Department of Radiology, Karolinska Institute, Huddinge Hospital Stockholm, Sweden
¶Deaconess Institute Oulu, Finland

revised 5 January 1996; accepted 5 January 1996.

Correspondence: G. Magnusson, Department of Physiology and Pharmacology, Karolinska Institute, Box 56 26, 114 86 Stockholm, Sweden

Abstract

Skeletal muscle adaptations to high intensity knee extensor strength and/or endurance training in patients with chronic heart failure were investigated. Eleven patients with chronic heart failure were randomized into two groups and exercised the m. quadriceps femoris 3 days/week for 8 weeks. After training, the maximal exercise intensity tolerated on the ergometer cycle was raised from 99 (32) to 114 (40) watts (W, P<0·05) for all 11 patients. Peak dynamic knee extensor work rate showed the greatest increase after endurance training (40%, P<0·01). Maximal dynamic and isometric strength were elevated by 40–45% (P<0·05) after strength training. The cross-sectional area of m. quadriceps femoris was increased in the strength-trained legs (9%, P<0·05), and the capillary per fibre ratio of m. vastus lateralis was raised by 47 and 58% in the endurance-trained legs (P<0·05). The oxidative enzyme activity in m. vastus lateralis was significantly raised above 50% after endurance training, whereas glycolytic enzyme activity was unaltered. The peripheral skeletal musculature in patients with chronic heart failure adapts fairly quickly to high intensity knee extensor training. This results in a marked rise in local, and a small rise in total work capacity, indicating maintained plasticity of skeletal muscle in chronic heart failure patients.

Key Words: Capillaries • endurance • fibre area • heart failure • knee extensions • muscle cross-sectional area • skeletal muscle • strength • training


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