Gademan Maaike G J, Swenne Cees A, Verwey Harriette F, van der Laarse Arnoud, Maan Arie C, van de Vooren Hedde, van Pelt Johannes, van Exel Henk J, Lucas Caroline M H B, Cleuren Ger V J, Somer Soeresh, Schalij Martin J, van der Wall Ernst E
Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
J Card Fail. 2007 May;13(4):294-303. doi: 10.1016/j.cardfail.2006.12.006.
In chronic heart failure (CHF), persistent autonomic derangement and neurohumoral activation cause structural end-organ damage, decrease exercise capacity, and reduce quality of life. Beneficial effects of pharmacotherapy and of exercise training in CHF have been documented at various functional and structural levels. However, pharmacologic treatment can not yet reduce autonomic derangement and neurohumoral activation in CHF to a minimum. Various studies suggest that exercise training is effective in this respect.
After reviewing the available evidence we conclude that exercise training increases baroreflex sensitivity and heart rate variability, and reduces sympathetic outflow, plasma levels of catecholamines, angiotensin II, vasopressin, and brain natriuretic peptides at rest.
Exercise training has direct and reflex sympathoinhibitory beneficial effects in CHF. The mechanism by which exercise training normalizes autonomic derangement and neurohumoral activation is to elucidate for further development of CHF-related training programs aimed at maximizing efficacy while minimizing workload.
在慢性心力衰竭（CHF）中，持续的自主神经紊乱和神经体液激活会导致终末器官结构损伤，降低运动能力，并降低生活质量。药物治疗和运动训练在CHF中的有益作用已在各种功能和结构层面得到证实。然而，药物治疗尚未能将CHF中的自主神经紊乱和神经体液激活降至最低。各种研究表明，运动训练在这方面是有效的。
在回顾现有证据后，我们得出结论，运动训练可提高压力反射敏感性和心率变异性，并降低静息时的交感神经输出、血浆儿茶酚胺、血管紧张素II、血管加压素和脑钠肽水平。
运动训练在CHF中具有直接和反射性的交感神经抑制有益作用。运动训练使自主神经紊乱和神经体液激活正常化的机制有待阐明，以便进一步开发CHF相关训练方案，在最小化工作量的同时最大化疗效。
