ELECTROMYOSTIMULATION OF LEG EXTENSORS IMPROVES THE VASOMOTION IN PATIENTS WITH CHRONIC HEART FAILURE

Study objective. Muscle myopathy is very common in patients with chronic heart failure (CHF). CHF prognosis may be improved by endurance training; however patients with advanced form of CHF are often excluded from standard exercise programs. Therefore, low-frequency electrical myostimulation (EMS) could be a suitable option to suppress muscle deterioration and to increase muscle strength. Aim of this study was to investigate whether exercise training (ET) or EMS could improve blood supply in stimulated muscles in patients with CHF. Methods. Thirty patients (6 women, 24 men, mean age 57 ± 6 years), EF < 40%, NYHA II-III) were enrolled. Patients were randomly assigned either to ET (n=15) or to EMS (n=15) group and underwent 8 weeks of given rehabilitation program. Patients in ET group underwent 8 weeks of bicycle exercise; EMS (10Hz frequency) was applied to the patients in EMS group. Stimulated were extensor muscles of both legs, 2x60min/day using stimulators Cefar Rehab X2 (COMPEX Co., CH) and self-adhesive electrodes (105cm2). Parameters collected before and after each program: distance walked in 6 min and Doppler velocimetry of left femoral artery to measure mean blood velocity at rest and during EMS. Results. Distance walked in 6 min improved significantly in both groups (+88m in ET group; and +52m in EMS group); Doppler study showed an improvement of vasodilative capacities after rehabilitation in both groups (+31.4cm/s in ET group, and +37.7cm/s in EMS group). Improvement of vasodilation was significantly higher in EMS group (P<0.05). Conclusion. Improvement of physical performance can be achieved either by classical bicycle training or by electrical stimulation; EMS seems to be more effective on the improvement of vasomotion.

Supported by the grant NS10096-4