The impact of exercise training on conduit artery wall thickness and remodeling in chronic heart failure patients.

Exercise training is an important adjunct to medical therapy in chronic heart failure, but the extent to which exercise impacts on conduit artery remodeling is unknown. The aim of this study was to evaluate the impact of aerobic and resistance exercise training modalities on arterial remodeling in patients with chronic heart failure. We randomized 36 untrained subjects with chronic heart failure to resistance training (58.8 ± 3.5 years), aerobic training (61.3 ± 2.8 years), or an untrained control group (64.4 ± 2.4 years). Peak oxygen consumption during cycle ergometry increased after 12 weeks in both the resistance and aerobic training (P < 0.001) groups, but not in controls, whereas leg strength only increased after resistance training (P < 0.05). Brachial artery wall thickness decreased in the resistance training group (475 ± 10 versus 443 ± 13 µm; P < 0.01), whereas no changes were apparent in the aerobic or control groups. Brachial diameter increased by ≈6% and ≈5% in the aerobic training and resistance training groups (P < 0.01), with no change evident in the control group. The wall:lumen ratio consequently declined in the resistance training group at 12 weeks (0.121 ± 0.004 versus 0.107 ± 0.004; P < 0.01) and increased in the control group (0.111 ± 0.006 versus 0.121 ± 0.009; P < 0.05). No wall:lumen change was evident in the aerobic training group. Our findings suggest that exercise has a systemic impact on remodeling of conduit arteries in humans and that resistance exercise training may be advantageous in subjects with chronic heart failure in this regard.

Impact of age, sex and exercise on brachial and popliteal artery remodelling in humans.

OBJECTIVE: To examine the impact of age, sex and exercise on wall thickness and remodelling in the popliteal and brachial arteries. METHODS: We compared wall thickness, lumen diameter and wall:lumen ratios in the brachial and popliteal arteries of 15 young (Y, 25.4+/-0.8 yr; 7M 8W) and 16 older sedentary (OS, 58.8+/-1.1 yr; 8M 8W) subjects, with 12 of the OS group also studied following 12 and 24 weeks exercise training. RESULTS: Wall thickness and lumen diameter were higher in the popliteal than the brachial artery for both groups (P<0.05); wall:lumen ratio was similar between arteries. Comparison of the Y and OS groups revealed no impact on wall thickness, whereas diameter values were higher in OS subjects (P<0.05). Whilst there were no significant differences in wall thickness between men and women in the Y or OS groups, diameter was larger in men than in women for both arteries (P<0.05). After 24 weeks of training the wall thickness of both arteries decreased (P<0.01) and the wall:lumen ratio of the brachial (P<0.01) and the popliteal (P<0.05) decreased. CONCLUSION: The cross-sectional results suggest that ageing was associated with increased lumen diameter, although wall:lumen ratio remained unchanged. Wall:lumen ratio was higher in women than men, irrespective of subject age or the artery studied. This related primarily to differences in lumen diameter between the sexes, as wall thickness did not significantly differ between men and women. Our longitudinal data strongly suggest that exercise training is associated with beneficial effects on conduit artery wall thickness and wall:lumen ratio in both upper and lower limbs in humans.