The hemodynamic effects of isotonic exercise using hand-held weights in patients with heart failure

Background: Controversy surrounds the use of resistance exercise in patient s with heart failure because of concerns that increases in rate-pressure pr oduct and systemic vascular resistance might lead to increased afterload an d decreased cardiac output. Methods: Following pharmacologic left ventricular unloading therapy using a pulmonary artery catheter, 34 patients with advanced heart failure perform ed isotonic weightlifting exercise at 50%, 65%, and 80% of the calculated o ne repetition maximum. Measurements were made of hemodynamics, ST segment, rate-pressure product, serum norepinephrine, rating of perceived exertion, and dysrhythmias following each exercise set. Results: Repeated analysis of variance showed significant increases in syst olic blood pressure (p = 0.0005), diastolic blood pressure (p = 0.01), rate -pressure product (p = 0.005); serum norepinephrine (p = 0.004), and rating of perceived exertion (p = 0.0005). However, systemic vascular resistance and cardiac output did not change significantly (p > 0.05). Pulmonary capil lary wedge pressures, the incidence of dysrhythmias, and ST segments did no t significantly differ from baseline. No patients experienced angina or dys pnea during the study. Conclusions: Isotonic exercise using hand-held weights was well tolerated h emodynamically and clinically, and no patients experienced adverse outcomes during exercise.