Background: Skeletal muscle maladaptations are highly prevalent among patients with chronic heart failure (CHF). This myopathy contribute to fatigue and dyspnea, the two major symptoms in CHF patients leading to decreased functional capacity. There is good evidence that physical exercise, in particular aerobic exercise, have positive effects on this condition by increasing functional capacity, improving NYHA class and to some extent reversing the skeletal muscle myopathy. However, less is known about the effect resistance training might have on the skeletal muscle in CHF. The potential effects of such training is important to assess since it would represent a treatment easily accessible and probably well tolerated, even by patients with advanced CHF.Methods: Searhes with the following key words were effectuated in the Medline and PubMed databases; CHF AND resistance training AND skeletal muscle, CHF AND strength training AND skeletal muscle. This supplied with relevant articles from the reference lists, the UpToDate database and chapters in relevant textbooks.Results:There is good evidence that CHF patients respond to resistance training by improving skeletal muscle strength and by increasing working capacity as measured by VO2max and 6 minute walk test. It is also evident that this type of training leads to an improvement in NYHA class as well as quality of life. Two studies reported enhanced perfusion of skeletal muscle as an effect of resistance training. ConclusionAlthough resistance training seems to have a positive effect on skeletal muscle strength and functional parameters, few have looked into-, and little is known concerning the structural and biochemical alterations in skeletal muscle that might mediate these effects. There is a need for further studies on the effects of isolated resistance training comprising healthy control groups.