COMPARISON OF TREADMILL AND BICYCLE EXERCISE IN PATIENTS WITH CHRONICHEART-FAILURE

The general opinion that treadmill exercise elicits circulatory reserv e more than bicycle exercise derives from studies conducted in normal subjects or subjects with coronary artery disease. To investigate if t his also occurs in patients with chronic heart failure (CHF), 40 patie nts (mean ejection fraction: 26 +/- 9 percent) pith normal pulmonary f unction underwent in random order both treadmill (Naughton modified pr otocol, holding on handrails permitted) and bicycle (10 W/min) maximal exercise over a 1-week period. Peak oxygen uptake (19.6 +/- 5.3 vs 17 .6 +/- 5.1 ml/min/kg, p<0.0001), ventilatory threshold (14.4 +/- 4.7 v s 12.0 +/- 3.5 ml/min/kg, p<0.0001), and minute ventilation (59 +/- 18 vs 55 +/- 15 L/min, p<0.05) were greater on treadmill than on bicycle . Heart rate, systolic blood pressure, breathing rate, respiratory exc hange ratio, perceived exertion scale, and lactate were identical. The coefficient of the correlation between oxygen uptake and time was gre ater with bicycle than with treadmill (r=0.97 +/- 0.04 vs 0.90 +/- 0.0 7, p<0.001). Thus, treadmill exercise is more suitable for determining peak oxygen uptake in patients with CHF. However, the increase in oxy gen uptake is more regular with bicycle exercise.