Effects of High-Intensity Aerobic Interval Training on Cardiopulmonary Function in Patients With Chronic Heart Failure at The University Teaching Hospital, Lusaka, Zambia

  • Mary Musonda Mikoloni Physiological Sciences department -University of Zambia
  • Nkhata A Loveness
  • Goma M Fastone
Keywords: Key words: Chronic Heart failure, Quality of life, Peripheral oxygen delivery, Cardiopulmonary capacity, Minnesota questionnaire

Abstract

Chronic heart failure patients present with a wide variety of symptoms such as, fatigue and dyspnea, which adversely affect their quality of life. Heart failure is a complex disease and a major cause of morbidity and mortality in developed and developing countries including Zambia. Through studies undertaken, high intensity aerobic interval training has been recommended in patients with chronic heart failure, to help improve symptoms and consequently the quality of life. Minimal research pertaining to effectiveness of aerobic exercise on various physiological parameters such as peripheral oxygen saturation, cardiopulmonary capacity and quality of life have been done in Africa and Zambia. Methods: This study evaluated the physiological effects of high intensity aerobic interval training on the cardiopulmonary function in New York Heart Association (NYHA) Class II and III chronic heart failure patients with a focus on peripheral oxygen delivery/saturation, cardiopulmonary capacity and the quality of life. This study utilised the Randomised Clinical Trial (RCT) study design and the study population was selected from the University Teaching Hospital-Heart clinic in Lusaka, Zambia. Results: A total number of 42 patients participated, and were randomly assigned to the two arms of the study. Twenty-one (21) were assigned to the interventional group (IG) and 21 to the control group (CG) respectively. The IG underwent a 12 week aerobic HIIT exercise-training program, while the CG was subjected to 30 minutes’ walk on a treadmill for the same period of 12 weeks. The expected primary outcomes were the baseline to endline differences in oxygen delivery/saturation readings, cardiopulmonary capacity test readings and the quality of life (measured using the Minnesota questionnaire) for both groups. The results obtained from the pulse oximeter readings, showed an increase in the oxygen saturation readings (97.90 to 98.62%), 6-minute walk distance readings (360.05 m to 429 m) and the questionnaire score totals of the different dimensions (physical, emotional/mental and socio-psychological factors) of the questionnaire (p-value ;0.0001) of the IG. The CG oxygen saturation readings (97.38 % to 97.90%) and 6-minute walk tests scores (359.14 to 370.9 m) showed minimal change. While, the questionnaire scores showed a statistical difference in the emotional/mental (p-value < 0.0001), physical (p=0.005) and socio-psychological factors (p- value < 0.0001). Conclusion: High intensity aerobic interval training has shown to improve the peripheral oxygen delivery, cardiopulmonary capacity and quality of life in chronic heart failure patients hence, must be considered as an adjunct therapy aside pharmacological management in stable chronic heart failure patients in Zambia.

References

REFERENCES
1. Ambrosy AP, et al., (2017) Aerobic exercise training and general health status in ambulatory heart failure patients with a reduced ejection fraction-Findings from the Heart Failure and A Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION)trial. Am Heart J. 2017 Apr;186:130-138. doi: 10.1016/j.ahj.2016.12.017. Epub 2017 Jan 19. PMID: 28454828.
2. Chansa P, Lakhi S, Andrews B, Kalinchenko S, SakrR (2014), Factors associated with mortality in adults admitted with heart failure at the University Teaching Hospital in Lusaka, Zambia. Med J Zambia 2014: 41 (1); 4 – 12
3. Dassanayaka S, Jones S.P. (2015), Recent Developments in Heart Failure. Circ. Res117: e58e63
4. Klindtworth K, Oster P, Hager K, Krause O, Bleidorn J, and Schneider N. (2015), “Living with and dying from advanced heart failure: Understanding the needs of older patients at the end of life,”BMC Geriatrics, vol. 15, no. 1, article no. 125
5. Lippi G and Sanchis-Gomar F, (2020), Global epidemiology and future trends of heart failure. AME Med J 2020;5:15
6. Meyer P, Gayda M, Juneau M and Nigam A, (2013), High-Intensity Aerobic Interval Exercise in Chronic Heart Failure
7. Strömberg A, Mårtensson J. (2003), Gender differences in patients with heart failure. Eur J Cardiovasc Nurs. 2003 Apr;2(1):7-18. doi: 10.1016/S1474-5151(03)00002-1. PMID: 14622644.
8. Zambroski C. H, Moser D. K, Bhat G, Ziegler C. (2005), Impact of symptom prevalence and symptom burden on quality of life in patients with heart failure. Eur J Cardiovasc Nurs;4(3):198-206.
9. Larsen, A.I. Dickstein, K. (2005) Exercise training in congestive heart failure. A review of the current status. Minerva Cardioangiol 2005; 53: 275 -86
10. Recommendations for exercise training in chronic heart failure patients. Eur Heart J 2001; 22: 125-35
11. Myers. J, (2008); Principles of Exercise Prescription for patients with chronic heart failure, Rev 2008; 13:61-8
12. Strömberg A, Mårtensson J. (2003), Gender differences in patients with heart failure. Eur J Cardiovasc Nurs. 2003 Apr;2(1):7-18. doi: 10.1016/S1474-5151(03)00002-1. PMID: 14622644.
13. Mandi G. D et al., (2020) Spectrum of heart failure in Sub-saharan Africa: data from a tertiary hospital-based registry in the eastern center of Burkina Faso
14. Smart N. A, Dieberg G, Giallauria F. (2013), Intermittent versus continuous exercise training in chronic heart failure A meta-analysis, Int J Cardiol 2013;166:352-8.
15. Ulbrich A. Z et al. (2015), Comparative effects of high intensity interval training versus moderate intensity continuous training on quality of life in patients with heart failure: Study protocol for a randomized controlled trial. Copyright © 2015 The Authors. Published by Elsevier B.V.
16. Tu et al. (2014), Exercise training was associated with a demonstrable benefit in the symptoms of depression in clinically stable HF patients. European Journal of Heart Failure©2014 European Society of Cardiology
17. Cho Y, Lee J. K, Kim D. H, Park J. H, Choi M, Kim H. J, Nam M. J, Lee K. U, Han K, Park Y. G. (2019), Factors associated with quality of life in patients with depression: A nationwide population-based study. PLoS One. 2019 Jul 11;14(7): e0219455. doi: 10.1371/journal.pone.0219455. PMID: 31295291; PMCID: PMC6623963
18. Mbakwem A, Aina F, Amadi C. (2016), Expert Opinion-Depression in Patients with Heart Failure: Is Enough Being Done? Card Fail Rev. 2016 Nov;2(2):110-112. doi: 10.15420/cfr.2016:21:1. PMID: 28785463; PMCID: PMC5490872.
19. Belardinelli et al., 2000 Physical exercise and quality of life in patients with cardiac disease
20. Kapenda C, Jere M, Chongwe G and Goma F. M (2015), Pulmonary Function Responses to Active Cycle Breathing Techniques in heart Failure patients at the University Teaching Hospital, Lusaka, Zambia
Published
2023-08-15
How to Cite
1.
Mikoloni M, Loveness N, Fastone G. Effects of High-Intensity Aerobic Interval Training on Cardiopulmonary Function in Patients With Chronic Heart Failure at The University Teaching Hospital, Lusaka, Zambia. University of Zambia Journal of Agricultural and Biomedical Sciences [Internet]. 15Aug.2023 [cited 14Jun.2024];6(4). Available from: https://journals.unza.zm/index.php/JABS/article/view/1021