Vasoreactivity before and after handgrip training in chronic heart failure patients

The purpose of this study was to investigate the vasodilatory and vasoconstrictor responses of the brachial artery in patients with chronic heart failure (CHF) and controls (CON) before and after a period of training and detraining.MethodsCHF (n = 10; age = 62 ± 8 yrs) and CON (n = 10; age = 55 ± 5 yrs) subjects completed 4 weeks of bilateral handgrip training (20 min; 60% of maximal handgrip strength; 15 grips*min−1; 4 days*week−1). Handgrip strength was measured using a hand dynamometer. Brachial artery flow-mediated dilation (BAFMD) and cold pressor test (CPT) responses were determined using ultrasonography prior to training, at the end of 4 weeks of training and following 4 weeks of detraining. Absolute (mm) BAFMD and CPT responses were combined to yield a vascular operating range (VOR).ResultsBaseline BAFMD was higher in CON (CHF: 2.98 ± 1.49%; CON: 6.21 ± 1.21%; p = 0.01), while CPT responses were higher in CHF (CHF: 3.38 ± 0.83%; CON: 2.46 ± 0.62%; p = 0.05). Baseline VOR tended to be greater in the CON subjects (CHF: 0.28 ± 0.05 mm; CON: 0.32 ± 0.12 mm; p = 0.06). Training increased handgrip strength (∼5%; p < 0.05, for both groups), BAFMD (CHF: 2.98 ± 1.49% to 3.75 ± 1.56%; CON: 6.21 ± 1.21% - 8.02 ± 1.75%; p = 0.01) and VOR (CHF: 0.28 ± 0.05 mm - 0.3 ± 0.09 mm; CON: 0.32 ± 0.12 mm - 0.42 ± 0.11 mm; p = 0.01). There were no significant changes in CPT responses. All markers approached pre-training values following detraining.ConclusionHandgrip exercise increases strength, BAFMD and VOR in both CHF and CON subjects. These improvements are transient and return to pre-training values after removal of the training stimulus.

► Handgrip exercise improves vascular function in heart failure and control subjects. ► This study reports on a vascular operating range which can be modified by exercise. ► Handgrip exercise contributes to an artery with greater physiological reserve. ► Removal of training returns vascular measures toward pre-training values.