Strength measurements and cardiopulmonary exercise testing
palpitations
HEART FAILURE
Strength was evaluated using one repetition maximum (1-RM) of each aforementioned exercise. In addition, at each visit cardiorespiratory fitness was assessed using spirometry (Vyntus™ CPX, Vyaire Germany, Hoechberg, Germany) and a cardiopulmonary exercise test (CPET); performed on a semi-recumbent ergometer (GE eBike, GE Healthcare GmbH, Solingen, Germany) at a constant speed of 55–70 revolutions per minute (rpm) beginning at a workload of 25 W ramping 15 W per minute until voluntary exhaustion occurred. Each participant continued for an additional 5-min recovery period at a workload of 25 W. In the CPET, spirometry data were collected using a digital spirometer (Vyntus™ CPX, Vyaire Germany, Hoechberg, Germany). Maximum oxygen consumption (VO2max), minute ventilation (VE), and HR (GE-Cardiosoft, GE Healthcare GmbH, Solingen, Germany) were monitored continuously.Safety of exercise was defined as no new symptoms or worsening of symptoms, no palpitations, no hospitalizations, and no clinical signs of heart failure.