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Eccentric exercise in coronary patients: central hemodynamic and metabolic responses
Katharina Meyer1, Roger Steiner, Paul Lastayo
1Swiss Cardiovascular Center Bern, Cardiology, University Clinic, University of Bern, Switzerland. katharina.e.meyer@freesurf.ch
Medicine and Science in Sports and Exercise
|July 4, 2003
Summary
Eccentric exercise, involving muscle lengthening, offers greater strength gains with lower cardiovascular stress than concentric exercise. This makes it a safe, effective training option for coronary patients with limited exercise tolerance.
Area of Science:
- Exercise Physiology
- Cardiovascular Health
- Rehabilitation Medicine
Background:
- Eccentric muscle contractions yield greater muscle mass and strength increases compared to concentric contractions.
- Eccentric exercise demonstrates lower energy demand and heart rate response relative to muscle force in healthy individuals.
- These characteristics suggest eccentric exercise as a viable alternative for patients with compromised cardiovascular tolerance.
Purpose of the Study:
- To evaluate the cardiovascular tolerance of eccentric exercise in patients with coronary heart disease.
- To compare the effects of eccentric versus concentric training on cardiovascular responses and exercise capacity.
- To determine the safety and efficacy of eccentric exercise as a high-load muscular training modality for cardiac patients.
Main Methods:
- 13 coronary patients (ages 40-66) with preserved or mildly reduced left ventricular function were enrolled.
- Patients were randomized into eccentric (ECC) or concentric (CON) training groups for 8 weeks.
- Training intensity was progressively increased to 60% of peak oxygen uptake (VO2peak).
Main Results:
- Maximum power output was fourfold higher in ECC compared to CON (357 W vs 97 W).
- Oxygen uptake and blood lactate levels were significantly lower in ECC, with similar perceived exertion.
- Central hemodynamics remained within normal ranges during ECC, comparable to CON, with no change in left ventricular function post-training.
Conclusions:
- Eccentric exercise effectively uncouples skeletal muscle load from cardiovascular stress.
- High-load eccentric training is a safe and effective exercise modality for low-risk coronary heart disease patients.
- Eccentric training can be recommended for cardiac rehabilitation, offering significant muscular benefits with minimal cardiovascular strain.