Effects of moderate-intensity strength training in people with heart failure

INTERVENTION: 3 months (3 times per week, 1 hour per session) progressive resistance training exercise using a multistation hydraulic resistance training system (Hydra‐Gym), leg cycling ergometers and a set of 5 stairs. The Hydra‐Gym has 6 resistance settings for each movement. All participants started on setting 2 and progression to the next resistance setting was determined by the number of repetitions achieved within a given work interval in the two previous training sessions. When a patient remained symptom‐free and recorded an increase of 25% in the number of repetitions achieved in a work interval during two consecutive training sessions, the resistance of that particular resistance activity was increased to the next setting. CONDITION: Chronic systolic heart failure PRIMARY OUTCOME: Combined measure of unilateral skeletal muscle ENDURANCE for knee and elbow extension/flexion (joules) using an isokinetic dynamometer (MERAC; Universal, Cedar Rapids, Iowa, USA) with microprocessor Combined measure of unilateral skeletal muscle STRENGTH for knee and elbow extension/flexion (nM) using an isokinetic dynamometer (MERAC; Universal, Cedar Rapids, Iowa, USA) with microprocessor SECONDARY OUTCOME: Angiotensin converting enzyme (ACE) genotype and its ability to predict responsiveness to resistance exercise training in these patients Forearm blood flow using venous occlusion plethysmography Heart rate variability using a Maclab system and Chart Extension software version 3.6.3 (ADI Instruments, Sydney, Australia) Peak total body oxygen consumption (VO2peak) determined during a symptom‐limited graded exercise test on an electronically‐braked bicycle ergometer (Ergomed, Siemens, Erlangen, Germany) INCLUSION CRITERIA: (i) Any aetiology of left ventricular systolic failure; (ii) left ventricular ejection fraction below 40%; (iii) stable pharmacological therapy with a minimum of two weeks unaltered drug therapy at entry.