Effects of Resistance Training on Sarcopenia in Older Patients With Chronic Heart Failure

Effects of Resistance Training on Sarcopenia in Older Patients With Chronic Heart Failure: A Randomized Controlled Trial

The goal of study is to evaluate the effects of an eight-week machine-based resistance training program on managing sarcopenia in older outpatients with chronic heart failure (HF) at Military Hospital 175.

The participants will be randomly assigned to two groups: One group received machine-based resistance training (MRT) at the hospital, while the other group received usual care (US). The outcomes will be measured in the participants after 8 weeks including handgrip strength, gait speed, performance on the five-times sit-to-stand test.

Inclusion Criteria:

• Aged ≥ 60 years old
• Meet the diagnostic criteria of 2019 AWGS2 sarcopenia, can be diagnosed once meeting (1) + (2) or (1) + (3) or (1) + (2) + (3): (1) Appendicular skeletal muscle mass (ASM): dual-energy X-ray absorptiometry (DXA) (male <7.0 kg/m², female <5.4 kg/m²). (2) Muscle strength: handgrip strength (male <28.0 kg, female <18.0 kg). (3) Physical performance: 6-meter walking speed <1.0 m/s.
• Meet the diagnostic criteria of heart failure following ESC 2021.
• Clearly understand the content and purpose of the study and sign the informed consent form.

Exclusion Criteria: There are contraindications for Exercise Testing in patients with stable heart failure according to ACSM 2022:

• Early stage after acute coronary syndrome (within the first 2 days)
• Unstable coronary artery disease
• Decompensated heart failure
• Acute venous thrombosis or recent arterial embolism (pulmonary or systemic)
• Acute myocarditis, pericarditis, endocarditis
• Aortic dissection of the valve
• Severe symptomatic aortic stenosis
• Acute systemic disease or fever
• Uncontrolled or life-threatening atrial or ventricular arrhythmias (including new-onset atrial fibrillation or flutter)
• Uncontrolled tachycardia (resting heart rate > 120 beats per minute)
• Third-degree AV block
• Uncontrolled diabetes
• Symptomatic orthostatic hypotension (> 20 mmHg)
• Gradually increasing fatigue during exercise or dyspnea at rest or with exertion within the past 3-5 days
• Significant myocardial ischemia at low workloads < 2 METs or 50W
• Relative contraindications according to ACSM 2022:
• Weight gain ≥ 1.8 kg in the past 1-3 days
• Simultaneous use of continuous or intermittent Dobutamine
• Decrease in blood pressure with exercise
• NYHA IV heart failure
• Complex ventricular arrhythmias at rest or with exertion
• Resting heart rate ≥ 100 bpm when lying down
• Comorbidities that limit exercise
• Severe obstructive hypertrophic cardiomyopathy
• Have participated in a cardiovascular rehabilitation program within the last 6 months
• Do not agree to participate in the study