This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ades, P. A. Articles by LeWinter, M. M. Search for Related Content PubMed PubMed Citation Articles by Ades, P. A. Articles by LeWinter, M. M.

Circulation, Vol 88, 572-577, Copyright © 1993 by American Heart Association

ARTICLES

Exercise conditioning in older coronary patients. Submaximal lactate response and endurance capacity

PA Ades, ML Waldmann, ET Poehlman, P Gray, ED Horton, ES Horton and MM LeWinter
University of Vermont College of Medicine, Division of Cardiology, Burlington.

BACKGROUND. Older coronary patients are at high risk of cardiac disability. Exercise conditioning programs have been demonstrated to improve functional capacity, particularly in younger coronary patients. In this study, the effects of aerobic conditioning on submaximal and maximal indicators of exercise performance were examined in 45 older coronary patients. METHODS AND RESULTS. Forty-five patients (mean age, 69 +/- 6 years; range, 62 to 82 years) entered 3-month and 12-month (n = 11) endurance training programs. Training effects were assessed during an exhaustive submaximal exercise protocol with measurement of endurance time, serum lactate, perceived exertion, and expired ventilatory measures. Exhaustive endurance time increased by more than 40% (30 +/- 10 to 41 +/- 10 minutes), with associated decreases in serum lactate, perceived exertion, minute ventilation, heart rate, and systolic blood pressure during steady-state exercise. Respiratory exchange ratio during steady-state exercise, an indicator of substrate utilization, decreased, indicating a shift toward greater use of free fatty acids as a metabolic fuel. In a subset of 10 patients, percent body fat was decreased (32 +/- 8% to 29 +/- 10%) over a period of 3 months. CONCLUSIONS. Older coronary patients respond to aerobic conditioning with remarkable improvements in submaximal endurance capacity, out of proportion to the more modest increases in VO2max. Activities that were exhaustive before training became sustainable for extended periods of time at a lower perceived exertion. Measurements of serum lactate, respiratory exchange ratio, and ventilation during steady-state exercise document that at an identical absolute work load after conditioning, exercise is performed using aerobic substrate to a greater degree, and ventilatory response to a given work load is lessened.

This article has been cited by other articles:

				P. D. Thompson Exercise Prescription and Proscription for Patients With Coronary Artery Disease Circulation, October 11, 2005; 112(15): 2354 - 2363. [Full Text] [PDF]

				D. Treat-Jacobson and R. A. Lindquist Functional Recovery and Exercise Behavior in Men and Women 5 to 6 Years Following Coronary Artery Bypass Graft (CABG) Surgery West J Nurs Res, August 1, 2004; 26(5): 479 - 498. [Abstract] [PDF]

				K. J. Stewart, D. Badenhop, P. H. Brubaker, S. J. Keteyian, and M. King Cardiac Rehabilitation Following Percutaneous Revascularization, Heart Transplant, Heart Valve Surgery, and for Chronic Heart Failure Chest, June 1, 2003; 123(6): 2104 - 2111. [Abstract] [Full Text] [PDF]

				A F Cooper, G Jackson, J Weinman, and R Horne Factors associated with cardiac rehabilitation attendance: a systematic review of the literature Clinical Rehabilitation, May 1, 2002; 16(5): 541 - 552. [Abstract] [PDF]

				M. A. Williams, J. L. Fleg, P. A. Ades, B. R. Chaitman, N. H. Miller, S. M. Mohiuddin, I. S. Ockene, C. B. Taylor, and N. K. Wenger Secondary Prevention of Coronary Heart Disease in the Elderly (With Emphasis on Patients >=75 Years of Age): An American Heart Association Scientific Statement From the Council on Clinical Cardiology Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention Circulation, April 9, 2002; 105(14): 1735 - 1743. [Full Text] [PDF]

				A.I Larsen, T Aarsland, M Kristiansen, A Haugland, and K Dickstein Assessing the effect of exercise training in men with heart failure. Comparison of maximal, submaximal and endurance exercise protocols Eur. Heart J., April 2, 2001; 22(8): 684 - 692. [Abstract] [PDF]

				P. A. Ades, M. L. Waldmann, W. L. Meyer, K. A. Brown, E. T. Poehlman, W. W. Pendlebury, K. O. Leslie, P. R. Gray, R. R. Lew, and M. M. LeWinter Skeletal Muscle and Cardiovascular Adaptations to Exercise Conditioning in Older Coronary Patients Circulation, August 1, 1996; 94(3): 323 - 330. [Abstract] [Full Text]