Characteristics of strength in subjects with cardiovascular disease


  • Stefano Scarpa University 'Giustino Fortunato' of Benevento, Italy
  • Alessandra Nart University of Padua, Italy



Cardiovascular disease, Strength, Upper limb, Lower limb


The aim of our work was to estimate the maximum strength of the upper and lower limbs (quadriceps, gastrocnemius, biceps, triceps, deltoid) in a group of patients affected by various cardiovascular diseases and compare it with that of a group of healthy and sedentary subjects (n = 20). We also wanted to assess whether there were differences in the maximum strength between different groups of cardiovascular diseases. This study presents many innovative elements, primarily two ones: (a) to recognize the importance of muscle strength as a health component in heart patients; (b) to establish a method for the assessment of strength based on estimation of 1RM. Here are presented the patients recruited on the basis of the basic pathology: 45 patients had chronic heart failure (CHF) in clinical stability for at least 3 months, class NYHA II-III; 21 patients had peripheral obliterative arteriopathy with claudication (POAC, stage IIa of Fontaine); 22 patients had undergone coronary angioplasty (coronary artery disease - CAD); 6 patients had undergone orthotopic cardiac transplant (HT) for at least 6 months. Chronic cardiovascular patients are characterized by a muscular impairment that parallels the history of the disease.


Download data is not yet available.


American College of Sports Medicine. ACSM's Guidelines for Exercise Testing and prescription. 7th ed. Philadelphia, Pa: Lippincott Williams and Wilkins, 2006.

American Association of Cardiovascular and Pulmonary Rehabilitation. Guidelines for Cardiac Rehabilitation and Secondary Prevention Programs. 4th ed. Champaign, Ill: Human Kinetics, 2004.

Ades PA, Savage PD, Brawner CA et al. Aerobic capacity in patients entering cardiac rehabilitation. Circulation 2006, 113:2706-2712.

Okada K, Naito AT, Higo T, et al. Wnt/β-Catenin Signaling Contributes to Skeletal Myopathy in Heart Failure via Direct Interaction With Forkhead Box O. Circ Heart Fail 2015; 8:799-808.

Drexler H. Peripheral circulatory adaptations to pump failure of the heart. Br Heart J 1994; 72:S22-27.

Greising SM, Gransee HM, Mantilla CB, Sieck GC. Systems biology of skeletal muscle: fiber type as an organizing principle. Wiley Interdiscip Rev Syst Biol Med 2012; 4:457–473.

Sullivan MJ, Green HJ, Cobb FR. Skeletal muscle biochemistry and histology in ambulatory patients with long-term heart failure. Circulation 1990; 81:518–527.

Rantanen T. Muscle strength, disability and mortality. Scand J Med Sci Sports 2003;13:3-8.

Hulsmann M, Quittan M, Berger R et al. Muscle strength as a predictor of long-term survival in severe congestive heart failure. Eur J Heart Fail 2004; 6:101-107.

Izawa KP, Watanabe S, Osada N et al. Handgrip strength as a predictor of prognosis in Japanese patients with congestive heart failure. Eur J Cardiovasc Prev Rehabil 2009; 16:21-27.

Purser JL, Kuchibhatla MN, Fillenbaum GG, et al. Identifying frailty in hospitalized older adults with significant coronary artery disease. J Am Geriatr Soc 2006; 54:1674-1681.

Ruiz JR, Sui X, Lobelo F et al. Association between muscular strength and mortality in men: prospective cohort study. BMJ 2008; 337:92-95.

Metter EJ, Talbot LA, Schrager M, Conwit RA. Arm-cranking muscle power and arm isometric muscle strength are independent predictors of all-cause mortality in men. J Appl Physiol 2004; 96:814-821.

Oliver D, Pflugfelder PW, McCartney N, et al. Acute cardiovascular responses to leg-press resistance exercise in heart transplant recipients. Int J Cardiol 2001;81:61-74.

World Health Organization. Global Recommendations on Physical Activity for Health. Switzerland: WHO Library Cataloguing-in-Publication Data, 2010.

Sarto P, Merlo L, Astolfo P, Sarto M, Bedin L, Noventa D for the Long Term Therapeutic Exercise Training (LoTTET) group. Comprehensive therapeutic program for cardiovascular patients: Role of a sports medicine unit in collaboration with local gymnasiums. J Cardiovasc Med 2009; 10:27-33.

Brzyski, M. Strength testing: Predicting a one-rep max from a reps-to-fatigue. J Phys Ed Rec Dance 1993; 64:88-90.

Izawa K, Hirano Y, Yamada S, Oka K, Omiya K, Iijima S. Improvement in physiological outcomes and health-related quality of life following cardiac rehabilitation in patients with acute myocardial infarction. Circulation 2004; 68:315-320.

McKelvie RS, Teo KK, Roberts R, et al. Effects of exercise training in patients with heart failure: the Exercise Rehabilitation Trial (EXERT). Am Heart J 2002; 144:23-30.

Williams M, Haskell W, Ades P et al. Resistance exercise in individuals with and without cardiovascular disease: 2007 update. Circulation 2007; 116:572-584.

Ghroubi S, Chaari M, Elleuch H et al. The isokinetic assessment of peripheral muscle function in patients with coronary artery disease: Correlations with cardiorespiratory capacity. Ann Readapt Med Phys 2007; 50:295-301.

Gayda M, Merzouk A, Choquet D, Doutrellot PL, Ahmaidi S. Aerobic capacity and peripheral skeletal muscle function in coronary artery disease male patients. Int J Sports Med 2003; 24:258-263.

Gualco A., Opasich C, Brazzo S et al. Metabolic frailty in malnourished heart failure patients. Monaldi Arch Chest Dis 2007; 68:115-120.

Braith RW, Limacher MC, Leggett SH, Pollock ML. Skeletal muscle strength in heart transplant recipients. J Heart Lung Transplant 1993;12:1018-1023.

Schmid J, Anderegg M, Romanens M et al. Combined endurance/resistance training early on, after a first myocardial infarction, does not induce negative left ventricular remodelling. Eur J Cardiovasc Prev Rehabil 2008; 15:341-346.

Volaklis KA, Tokmakidis, SP. Resistance exercise training in patients with heart failure. Sports Med 2005; 35:1085-1103.



How to Cite

Scarpa, S., & Nart, A. (2019). Characteristics of strength in subjects with cardiovascular disease. Journal of Human Sport and Exercise, 14(1proc), S92-S99.