Effect of aerobic interval training on erythrocyte rheological and hemodynamic functions in heart failure patients with anemia

Int J Cardiol. 2013 Sep 30;168(2):1243-50. doi: 10.1016/j.ijcard.2012.11.053. Epub 2012 Nov 27.

Abstract

Background: Anemia disturbs hemorheological/hemodynamic properties, whereas aerobic interval training (AIT) achieves a superior aerobic fitness in patients with heart failure (HF). This study investigated whether AIT influences functional capacity by modulating hemorheological/hemodynamic functions in HF patients with/without anemia.

Methods: Sixty HF patients were divided into non-anemic (HF-NA, hemoglobin >/= 12 g/dL in women/ >/= 13 g/dL in men; n=30) and anemic (HF-A, hemoglobin<11 g/dL in women/<12 g/dL in men; n=30) groups, and 30 normal counterparts were enrolled as a control group. These HF patients performed AIT (3-minute intervals at 40% and 80%VO(2peak)) on a bicycle ergometer for 30 min/day, 3 days/week for 12 weeks. Erythrocyte rheological and central/peripheral hemodynamic characteristics were determined by slit-flow ektacytometer and bioreactance-based device/near infrared spectrometer, respectively.

Results: In both HF-NA and HF-A groups, the AIT regimen 1) reduced blood senescent/spherical erythrocyte counts, 2) diminished the values of critical shear stresses for disaggregation and half-maximal deformation of erythrocytes, 3) enhanced cardiac output during exercise, 4) heightened VO(2peak) and O2 uptake efficiency slope (OUES), and 5) decreased plasma myeloperoxidase and interleukin-6 levels. However, AIT increased the amounts of blood distributed to the frontal cerebral lobe and vastus lateralis muscle during exercise in HF-NA group but not in HF-A group. Additionally, HF-A group exhibited fewer the enhancements of VO(2peak) and OUES caused by AIT than HF-NA group did.

Conclusion: AIT improves aerobic capacity and efficiency by depressing aggregability and enhancing deformability of erythrocytes in patients with HF. However, anemic comorbidity attenuates the adaptations of cerebral/muscular hemodynamic responses to exercise following this regimen.

Keywords: Erythrocyte; Exercise training; Heart failure; Hemodynamics; Rheology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anemia / blood*
  • Anemia / epidemiology
  • Anemia / therapy*
  • Cell Shape / physiology
  • Erythrocytes / physiology*
  • Exercise / physiology*
  • Exercise Test / methods
  • Female
  • Heart Failure / blood*
  • Heart Failure / epidemiology
  • Heart Failure / therapy*
  • Hemodynamics / physiology*
  • Humans
  • Male
  • Middle Aged
  • Rheology / methods*
  • Treatment Outcome