Wielenga R P, Huisveld I A, Bol E, Dunselman P H, Erdman R A, Baselier M R, Mosterd W L
Department of Cardiology, Ignatius Hospital, Breda, The Netherlands.
Eur Heart J. 1999 Jun;20(12):872-9. doi: 10.1053/euhj.1999.1485.
Physical training is considered to be safe and beneficial as part of the treatment in heart failure patients. Prospective, sufficiently large studies are still needed to confirm this hypothesis.
In a prospective study, 80 patients with chronic heart failure class II and III (age, 56.6+/-8.3 years; left ventricular ejection fraction, 26.5+/-9.6%) were randomized to an endurance training group or to a control group with continuation of optimal pharmacological treatment.
No training-related adverse event was reported, implying that the training programme was safe for these groups of chronic heart failure patients. Between-group comparison of changes revealed that training increased exercise time (from 608+/-35 to 738+/-40 s, P<0.0001), anaerobic threshold (from 10.5+/-0.4 to 11.8+/-0.3 ml x kg-1 min-1, P<0.05), and decreased the ventilatory equivalent for carbon dioxide at submaximal exercise level (from 2.8+/-0.1 to 2.7+/-0.1, P<0.05). Training did not increase peak oxygen consumption (15.2+/-0.5 to 16. 6+/-0.5 ml x kg-1 min-1, ns). An improvement in patients' assessment of quality of life was observed. There was a significant correlation between physiological and psychological improvements. Training was not effective in patients whose exercise test at entry had a duration of less than 7 min. None of the other baseline data could predict an effective training response.
Physical training in chronic heart failure patients class II and III is safe and results in significant improvements in exercise time, anaerobic threshold, ventilatory equivalent for carbon dioxide at submaximal exercise level and quality of life.
体育锻炼被认为是心力衰竭患者治疗的一部分，安全且有益。仍需前瞻性、足够大样本的研究来证实这一假设。
在一项前瞻性研究中，80例II级和III级慢性心力衰竭患者（年龄56.6±8.3岁；左心室射血分数26.5±9.6%）被随机分为耐力训练组或继续接受最佳药物治疗的对照组。
未报告与训练相关的不良事件，这表明该训练方案对这些慢性心力衰竭患者群体是安全的。组间变化比较显示，训练增加了运动时间（从608±35秒增至738±40秒，P<0.0001）、无氧阈值（从10.5±0.4增至11.8±0.3毫升·千克⁻¹·分钟⁻¹，P<0.05），并降低了次最大运动水平时二氧化碳的通气当量（从2.8±0.1降至2.7±0.1，P<0.05）。训练未增加峰值耗氧量（从15.2±0.5增至16.6±0.5毫升·千克⁻¹·分钟⁻¹，无显著差异）。观察到患者对生活质量的评估有所改善。生理和心理改善之间存在显著相关性。对于入组时运动试验持续时间少于7分钟的患者，训练无效。其他基线数据均无法预测有效的训练反应。
II级和III级慢性心力衰竭患者进行体育锻炼是安全的，并能显著改善运动时间、无氧阈值、次最大运动水平时二氧化碳的通气当量和生活质量。
