The 'aerobic/resistance/inspiratory muscle training hypothesis in heart failure'.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
moderate continuous aerobic training | no change | exercise programme efficacy | heart failure patients | null | indicates that the 'crème de la crème' exercise programme for this population remains to be found | #1 |
high intensity interval training | no change | exercise programme efficacy | heart failure patients | null | indicates that the 'crème de la crème' exercise programme for this population remains to be found | #2 |
combined ARIS muscle training | increase | exercise pathophysiological and functional benefits | heart failure patients | null | may result in maximal exercise pathophysiological and functional benefits | #3 |
null | decrease | muscle endurance | heart failure patients | null | exercise and functional intolerance in heart failure patients are associated with reduced muscle endurance | #4 |
null | decrease | muscle strength | heart failure patients | null | exercise and functional intolerance in heart failure patients are associated with reduced muscle strength | #5 |
null | decrease | inspiratory muscle function | heart failure patients | null | exercise and functional intolerance in heart failure patients are associated with decreased inspiratory muscle function | #6 |
aerobic training (AT) | null | reduced muscle endurance | heart failure patients | null | indication for | #7 |
resistance training (RT) | null | reduced muscle strength | heart failure patients | null | addition to AT | #8 |
inspiratory muscle training (IMT) | null | decreased inspiratory muscle function | heart failure patients | null | addition to AT | #9 |
Evidence from large multicentre exercise intervention trials in heart failure patients, investigating both moderate continuous aerobic training and high intensity interval training, indicates that the 'crème de la crème' exercise programme for this population remains to be found. The 'aerobic/resistance/inspiratory (ARIS) muscle training hypothesis in heart failure' is introduced, suggesting that combined ARIS muscle training may result in maximal exercise pathophysiological and functional benefits in heart failure patients. The hypothesis is based on the decoding of the 'skeletal muscle hypothesis in heart failure' and on revision of experimental evidence to date showing that exercise and functional intolerance in heart failure patients are associated not only with reduced muscle endurance, indication for aerobic training (AT), but also with reduced muscle strength and decreased inspiratory muscle function contributing to weakness, dyspnoea, fatigue and low aerobic capacity, forming the grounds for the addition of both resistance training (RT) and inspiratory muscle training (IMT) to AT. The hypothesis will be tested by comparing all potential exercise combinations, ARIS, AT/RT, AT/IMT, AT, evaluating both functional and cardiac indices in a large sample of heart failure patients of New York Heart Association class II-III and left ventricular ejection fraction ≤35% ad hoc by the multicentre randomized clinical trial, Aerobic Resistance, InSpiratory Training OutcomeS in Heart Failure (ARISTOS-HF trial).