在慢性心力衰竭患者中，涉及较小肌肉量的有氧训练比涉及较大肌肉量的训练显示出更高的效率。

Aerobic training involving a minor muscle mass shows greater efficiency than training involving a major muscle mass in chronic heart failure patients.

作者信息

Tyni-Lenné R, Gordon A, Jensen-Urstad M, Dencker K, Jansson E, Sylvén C

机构信息

Department of Physical Therapy, Karolinska Institute and Huddinge University Hospital, Sweden.

出版信息

J Card Fail. 1999 Dec;5(4):300-7. doi: 10.1016/s1071-9164(99)91334-9.

DOI:10.1016/s1071-9164(99)91334-9

PMID:10634671

Abstract

BACKGROUND

Beneficial training outcomes have been reported in sedentary patients with chronic heart failure (CHF) after exercise training. However, data on training effects in previously trained patients, as well as comparisons of different exercise modes, are lacking. The aim of this study is to compare exercise training on a cycle ergometer (major muscle mass) and aerobic knee-extensor training (minor muscle mass) in previously trained patients with CHF.

METHODS AND RESULTS

Twenty-four men and women (age, 63 +/- 10 years [mean +/- SD]) with stable, moderate CHF (left ventricular ejection fraction, 30% +/- 11%) who had completed their first exercise training period more than 1 year ago were allocated to either the exercise or control group. After stratification for sex, age, ejection fraction, and cardiac output response, the training group was further randomized to either cycle ergometer or knee-extensor training for 8 weeks. The control and training patients did not differ at baseline, and the measured variables did not change in the control group during the 8 weeks. Citrate synthase activity in skeletal muscle increased after cycle training (23%; P < .02) and knee-extensor training (45%; P < .008), and blood lactate concentration at submaximal intensities decreased (P < .04) in both groups. However, only after knee-extensor training did the peak oxygen uptake increase (19%; P < .01) and sympathetic nervous system activity, measured as plasma norepinephrine concentration at rest (P < .05) and during exercise (P < .008), decrease. Minnesota Living with Heart Failure questionnaire scores also showed improvement in the health-related quality of life (P < .05) only after knee-extensor training.

CONCLUSION

Physical training is beneficial in previously trained patients with CHF. Aerobic training involving a minor muscle mass shows greater efficiency than training involving a major muscle mass.

摘要

背景

有报道称，运动训练对久坐不动的慢性心力衰竭（CHF）患者有有益的训练效果。然而，关于既往接受过训练的患者的训练效果以及不同运动模式比较的数据尚缺乏。本研究的目的是比较既往接受过训练的CHF患者进行蹬车测力计训练（主要肌肉群）和有氧伸膝训练（次要肌肉群）的效果。

方法与结果

24名男性和女性（年龄63±10岁[均值±标准差]），患有稳定的中度CHF（左心室射血分数30%±11%），且在1年多前完成了首个运动训练阶段，被分配至运动组或对照组。在对性别、年龄、射血分数和心输出量反应进行分层后，训练组进一步随机分为蹬车测力计训练组或伸膝训练组，为期8周。对照组和训练组患者在基线时无差异，对照组在8周内测量变量未发生变化。两组骨骼肌中的柠檬酸合酶活性在蹬车训练后增加（23%；P<0.02），在伸膝训练后增加（45%；P<0.008），两组次最大强度时的血乳酸浓度均降低（P<0.04）。然而，仅在伸膝训练后，峰值摄氧量增加（19%；P<0.01），交感神经系统活动降低，交感神经系统活动以静息时（P<0.05）和运动时（P<0.008）的血浆去甲肾上腺素浓度衡量。明尼苏达心力衰竭生活问卷评分也仅在伸膝训练后显示健康相关生活质量有所改善（P<0.05）。