Eccentric Muscle Training in Cardiac Rehabilitation

Eccentric Muscle Training in Cardiac Rehabilitation: Randomized Controlled Trial to Evaluate Effectiveness and Feasibility in Heart Failure Patients With Reduced Ejection Fraction

The goal of this interventional study is to assess the training effects in a training schedule in which eccentric overload training and eccentric cycle training are used.

Researchers will compare a training program of eccentric overload training and eccentric cycling training with a traditional training program of strength and cardio training in people with heart failure with reduced ejection fraction.

This study will be delivered in a cardiac rehabilitation setting.

Patients with HFrEF experience in general more difficulties completing exercise training trajectory because of low physical fitness and multiple comorbidies.

In this study traditional exercise capacity outcomes are assessed eg. endurance capacity, muscle strength and muscle mass in patients with HFrEF.

It is hypothesized that greater muscle strength and muscle mass are obtained by eccentric muscle training in comparison with conventional training because higher training volumes can be used with a lower metabolic demand.

Possibly, a better outcome regarding muscle function and mass will influence VO2 peak and functionality in this patient population.

Inclusion Criteria:

• HFrEF patients with ejection fraction <40%
• Exercise intolerance (<85% of predicted VO2 peak)
• clinically stable for > 6 weeks, optimal medical treatment for > 6 weeks

Exclusion Criteria:

• Contra indications for cardiac exercise rehabilitation as per consensus guidelines and recommendations
• Musculoskeletal disorders that hamper (progression in) strength training
• Non-stabilized acute coronary syndrome
• Current acute heart failure (decompensation)
• Patient having sustained a recent (<3 months) procedure that could act as a confounder to increase VO2peak (i.e., coronary artery bypass graft surgery, percutaneous coronary intervention, cardiac resynchronization therapy, valve surgery or reparation)