Effects of Exercise Training in Patients with Chronic Heart Failure and Sleep Apnea |
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| Authors: | Linda M. Ueno Luciano F. Drager Ana C. T. Rodrigues Maria U. P. B. Rondon Ana M. F. W. Braga Wilson Mathias Jr. Eduardo M. Krieger Antonio C. P. Barretto Holly R. Middlekauff Geraldo Lorenzi-Filho Carlos E. Negr?o |
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| Affiliation: | 1.School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil;2.Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil;3.Division of Cardiology, David Geffen School of Medicine at the University of California, Los Angeles, CA;4.School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil |
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| Abstract: | ![]()
Study Objectives: To test the effects of exercise training on sleep and neurovascular control in patients with systolic heart failure with and without sleep disordered breathing.Design:Prospective interventional study.Setting:Cardiac rehabilitation and exercise physiology unit and sleep laboratory.Patients:Twenty-five patients with heart failure, aged 42 to 70 years, and New York Heart Association Functional Class I-III were divided into 1 of 3 groups: obstructive sleep apnea (n = 8), central sleep apnea (n = 9) and no sleep apnea (n = 7).Interventions:Four months of no-training (control) followed by 4 months of an exercise training program (three 60-minute, supervised, exercise sessions per week).Measures and Results:Sleep (polysomnography), microneurography, forearm blood flow (plethysmography), peak VO2, and quality of life were evaluated at baseline and at the end of the control and trained periods. No significant changes occurred in the control period. Exercise training reduced muscle sympathetic nerve activity (P < 0.001) and increased forearm blood flow (P < 0.01), peak VO2(P < 0.01), and quality of life (P < 0.01) in all groups, independent of the presence of sleep apnea. Exercise training improved the apnea-hypopnea index, minimum O2 saturation, and amount stage 3-4 sleep (P < 0.05) in patients with obstructive sleep apnea but had no significant effects in patients with central sleep apnea.Conclusions.The beneficial effects of exercise training on neurovascular function, functional capacity, and quality of life in patients with systolic dysfunction and heart failure occurs independently of sleep disordered breathing. Exercise training lessens the severity of obstructive sleep apnea but does not affect central sleep apnea in patients with heart failure and sleep disordered breathing.Citation:Ueno LM; Drager LF; Rodrigues ACT; Rondon MUPB; Braga AMFW; Mathias W; Krieger EM; Barretto ACP; Middlekauff HR; Lorenzi-Filho G; Negrão CE. Effects of exercise training in patients with chronic heart failure and sleep apnea. SLEEP 2009;32(5):637-647. |
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| Keywords: | Heart failure exercise training sleep apnea forearm blood flow muscle sympathetic nerve activity |
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