The Effects of Isometric Exercise Using Hand-Held Weights in Heart Failure Patients

Background: The use of resistance exercise in patients with heart failure (HF) is controversial because of concerns that increases in rate pressure product and systemic vascular resistance might lead to increased afterload and decreased cardiac output.Methods: Following pharmacologic left ventricular unloading therapy using a pulmonary artery catheter, 34 patients with advanced heart failure performed isotonic weight lifting exercise at 50%, 65%, and 80% of calculated one repetition maximum. Hemodynamics, ST segment, rate pressure product, serum norepinephrine, rating of perceived exertion, and dysrhythmias were measured following each exercise set.Results: Repeated analysis of variance showed significant increases in systolic blood pressure (p = .0005); diastolic blood pressure (p = .01); rate pressure product (p = .005); serum norepinephrine (p = .004) and rating or perceived exertion (p = .0005). However, systemic vascular resistance and cardiac output did not change significantly (p > .05). Pulmonary capillary wedge pressures, the incidence of dysrhythmias and ST segments were not significantly different compared to baseline. No patients experienced angina or dyspnea during the study.Conclusions: Isotonic exercise using hand-held weights was well tolerated hemodynamically and clinically with no patients experiencing adverse outcomes during exercise.