OBJECTIVE: To examined the effects of different training modalities on exercise capacity (VO2peak), systolic function, muscular strength and endurance and quality of life in heart failure patients. DESIGN: Randomized controlled trial. SETTING: Cardiac rehabilitation centre in Canada. SUBJECTS: Forty-two individuals with heart failure (62 +/- 12 years; New York Heart Association (NYHA) classes I to III). INTERVENTIONS: Aerobic training (n = 14), combined aerobic and resistance training (n = 15) or usual care (n = 13) three times per week for 12 weeks. MAIN MEASURES: (1) VO2peak measured by symptom-limited graded exercise test on cycle ergometer; (2) systolic function assessed by two-dimensional echocardiography; (3) muscular strength and muscular endurance measured by one-repetition maximum procedure; and (4) quality of life assessed by questionnaires. RESULTS: In the intention-to-treat analysis, neither aerobic nor combined aerobic and resistance training significantly improved VO2peak, systolic function or quality of life compared with usual care. However, combined aerobic and resistance training significantly improved upper extremity strength (40.7 (14.0) to 48.5 (16.0) kg, p < 0.05) and muscular endurance (5.7 (2.7) to 11.6 (7.6) reps, p < 0.05) compared with aerobic training or usual care. In compliant participants (exercise adherence 80%), VO2peak increased in the aerobic group (16.9 (6.0) to 19.0 (6.8), p = 0.026) and tended to increase in the combined training group (15.9 (5.0) to 17.6 (5.6), p = 0.058) compared with usual care. Quality of life was improved in the aerobic group only. CONCLUSIONS: Both aerobic and combined aerobic and resistance training are effective interventions to improve VO2peak in compliant heart failure patients. Combined training may be more effective in improving muscle strength and endurance.

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