Exercise dose-response of the V? E/V?CO 2 slope in postmenopausal women in the DREW study

Abstract

Purpose: Being overweight/obese, having hypertension, and being postmenopausal are risk factors for the development of congestive heart failure (CHF). A characteristic of CHF is an abnormal V?E/V?CO2 slope, which is predictive of mortality in patients with CHF. Although the V?E/V?CO2 slope is well established in CHF patients, little is known regarding interventions for 'at-risk' populations. Methods: We examined the V?E/V?CO2 slope in 401 sedentary, overweight, moderately hypertensive women randomized to 6 m of nonexercise (control) or 4 kcal·kg?1·wk?1 (KKW), 8 KKW, or 12 KKW of exercise at an intensity corresponding to 50% of baseline V?O2max. We examined trends in exercise treatment dose versus change in mean V?E/V?CO2 slope using a linear regression model (KKW vs V?E/V?CO2 slope) and a linear mixed model. Results: Regression analysis showed a significant trend for a reduction in the V?E/V?CO2 slope from baseline (mean ± SD: 32.6 ± 6.3; P < 0.004). When expressed as mean change (95% confidence interval (CI)) from baseline, we observed significant reductions in the V?E/V?CO2 slope for the 8-KKW (?1.14; 95% CI, ?1.5 to ?0.2) and 12-KKW (?1.67; 95% CI, ?2.3 to ?0.3) groups. No significant effect was noted for the 4-KKW (?0.4; 95% CI, ?1.2 to 0.15) group. Conclusion: Moderate-intensity aerobic exercise at doses of 8 KKW or greater seems to present an adequate dose of exercise to promote small but significant reductions in the V?E/V?CO2 slope in postmenopausal women who exhibit risk factors associated with the development of CHF.