Effects of eccentric cycling training on aerobic and functional capacity in patients with heart failure: A randomised...

To evaluate the effects of eccentric and conventional concentric cycle training on aerobic and functional capacity and health-related quality of life in patients with heart failure.

Seventy participants (45 after attrition) with heart failure were randomised 1:1 to eccentric (n = 34) or concentric (n = 36) cycling and 45 completed the intervention (eccentric n = 25; concentric n = 20). Each intervention involved 2-weeks familiarisation and 12-weeks of training, performed at matched relative intensity (40-70% of heart rate reserve), twice weekly.

The primary outcome was peak oxygen consumption (V̇O₂peak); secondary outcomes included 6-minute walk distance, 30 s sit-to-stand, timed up-and-go, and the Minnesota Living with Heart Failure questionnaire to determine quality of life. Intention to treat analysis was conducted using linear mixed models.

The mean age of participants was 57 ± 13 years and 20% were female. The mean left ventricular ejection fraction was 31 ± 10%. Both interventions significantly enhanced V̇O₂peak (eccentric: 17.7 ± 4.8 to 19.1 ± 5.2; concentric: 17.4 ± 6.0 to 19.8 ± 6.0 mL·kg^-1·min^-1, P = 0.002), 6-min walk distance (eccentric: 476 ± 77 to 547 ± 80; concentric: 485 ± 106 to 516 ± 113 m, P < 0.001), and 30 s sit-to-stand (eccentric: 12 ± 3 to 16 ± 3; concentric: 13 ± 4 to 14 ± 3 reps, P < 0.001). Timed up-and-go (eccentric: 7.2 ± 1.2 to 6.2 ± 1.1; concentric: 7.6 ± 1.5 to 7.3 ± 1.9 s, P < 0.001) and the Minnesota Living with Heart Failure questionnaire mental domain improved following eccentric, but not concentric cycling. Perceived exertion was lower during exercise training in eccentric cycling (P = 0.018).

Both eccentric cycling and concentric cycling improved aerobic capacity and functional outcomes in compromised patients with heart failure.