Exercise-based rehabilitation with or without blood flow restriction in individuals with heart failure: Protocol for the rehab-washout HF trial.
This trial compares two types of resistance training in heart failure patients to determine which is more effective in improving clinical outcomes.
Where it sits
this study against the rest of the slu-pp-332 (exercise mimetic) corpusSummary and findings
This study measures the effects of conventional moderate-to-high intensity resistance training versus low-load resistance training with blood flow restriction in patients with heart failure. The intervention involves 52 patients classified as NYHA functional class II-III over a duration of 4 months, with outcomes assessed at 8 months post-intervention. The primary outcome is the change in serum NT-proBNP levels.
Abstract
<h4>Background</h4>Heart failure (HF) significantly reduces functional capacity and quality of life in patients classified as New York Heart Association (NYHA) functional class II-III. While cardiopulmonary rehabilitation (CR) is beneficial, innovative strategies are required to improve accessibility and effectiveness for individuals unable to tolerate high hemodynamic loads.<h4>Aims</h4>To compare the effects of conventional moderate-to-high intensity resistance training (CRT) versus low-load resistance training combined with blood flow restriction (BFRRT) on clinical, functional, and biochemical outcomes in HF patients.<h4>Methods and analysis</h4>This randomized, prospective, parallel-group clinical trial will include 52 patients (NYHA II-III) allocated into CRT (60-80% 1RM) or BFRRT (20-30% 1RM, calibrated at 50% arterial occlusion pressure) groups. The supervised intervention lasts 4 months, with an 8-month post-intervention follow-up. The primary outcome is the change in serum NT-proBNP levels. Secondary outcomes include quality of life, echocardiographic ventricular function, functional capacity, and clinical events. Advanced statistical models and exploratory machine learning analyses with k-fold cross-validation will be utilized for predictive modeling and exploring personalized medicine strategies.<h4>Implications</h4>The REHAB-WASHOUT HF trial aims to establish an effective, safe, and accessible therapeutic approach for HF rehabilitation, potentially enhancing clinical outcomes and guiding personalized prescriptive strategies in cardiovascular rehabilitation.<h4>Ethics and registration</h4>Approved by the local institutional review board (No. 5.848.965; CAAE 64955022.9.1001.0029). Trial registration: RBR-5y8k7d7.
Background
Heart failure significantly reduces functional capacity and quality of life in patients classified as NYHA functional class II-III. Previous studies have shown that cardiopulmonary rehabilitation can be beneficial, but there is a need for innovative strategies to improve accessibility and effectiveness for patients unable to tolerate high hemodynamic loads. This study aims to address this gap by comparing conventional resistance training with low-load resistance training combined with blood flow restriction.
Methods
This is a randomized, prospective, parallel-group clinical trial involving 52 patients with heart failure classified as NYHA functional class II-III. Participants will be allocated to either conventional resistance training (CRT) or low-load resistance training with blood flow restriction (BFRRT). The CRT group will train at 60-80% of their one-repetition maximum (1RM), while the BFRRT group will train at 20-30% of 1RM, calibrated at 50% arterial occlusion pressure. The intervention will last for 4 months, with outcomes assessed at 8 months post-intervention.
Results
Not reported in abstract.
Interpretation
Not reported in abstract.
Key findings
- 52 patients allocated into CRT (60-80% 1RM) or BFRRT (20-30% 1RM, calibrated at 50% arterial occlusion pressure).
- Supervised intervention lasts 4 months, with an 8-month post-intervention follow-up.
- Primary outcome is change in serum NT-proBNP levels.
Limitations
- small n=52
- 4-month intervention may not capture long-term effects
- no reported results or outcomes in abstract