Schmid Jean-Paul, Anderegg Matthias, Romanens Michel, Morger Cyrill, Noveanu Markus, Hellige Gerrit, Saner Hugo
Department of Cardiology, Cardiovascular Prevention and Rehabilitation, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.
Eur J Cardiovasc Prev Rehabil. 2008 Jun;15(3):341-6. doi: 10.1097/HJR.0b013e3282f5dbf5.
Resistance training (RT) is safe and practicable in low-risk populations with coronary artery disease. In patients with left ventricular (LV) dysfunction after an acute ischaemic event, few data exist about the impact of RT on LV remodelling.
In this prospective, randomized, controlled study, 38 patients, after a first myocardial infarction and a maximum ejection fraction (EF) of 45%, were assigned either to combined endurance training (ET)/RT (n=17; 15 men; 54.7+/-9.4 years and EF: 40.3+/-4.5%) or to ET alone (n=21; 17 men; 57.0+/-9.6 years and EF: 41.9+/-4.9%) for 12 weeks. ET was effectuated at an intensity of 70-85% of peak heart rate; RT, between 40 and 60% of the one-repetition maximum. LV remodelling was assessed by MRI.
No statistically significant differences between the groups in the changes of end-diastolic volume (P=0.914), LV mass (P=0.885) and EF (P=0.763) were observed. Over 1 year, the end-diastolic volume increased from 206+/-41 to 210+/-48 ml (P=0.379) vs. 183+/-44 to 186+/-52 ml (P=0.586); LV mass from 149+/-28 to 155+/-31 g (P=0.408) vs. 144+/-36 to 149+/-42 g (P=0.227) and EF from 49.1+/-12.3 to 49.3+/-12.0% (P=0.959) vs. 51.5+/-13.1 to 54.1% (P=0.463), in the ET/RT and ET groups, respectively. Peak VO2 and muscle strength increased significantly in both groups, but no difference between the groups was noticed.
RT with an intensity of up to 60% of the one-repetition maximum, after an acute myocardial infarction, does not lead to a more pronounced LV dilatation than ET alone. A combined ET/RT, or ET alone, for 3 months can both increase the peak VO2 and muscle strength significantly.
抗阻训练（RT）在低风险冠心病患者中是安全可行的。对于急性缺血事件后出现左心室（LV）功能障碍的患者，关于RT对LV重塑影响的数据很少。
在这项前瞻性、随机、对照研究中，38例首次心肌梗死后且最大射血分数（EF）为45%的患者，被随机分为耐力训练（ET）/RT联合组（n = 17；15名男性；54.7±9.4岁，EF：40.3±4.5%）或单纯ET组（n = 21；17名男性；57.0±9.6岁，EF：41.9±4.9%），为期12周。ET以心率峰值的70 - 85%强度进行；RT以一次最大重复量的40 - 60%进行。通过MRI评估LV重塑情况。
两组间舒张末期容积变化（P = 0.914）、LV质量（P = 0.885）和EF（P = 0.763）无统计学显著差异。在1年多的时间里，ET/RT组舒张末期容积从206±41增加到210±48 ml（P = 0.379），而单纯ET组从183±44增加到186±52 ml（P = 0.586）；LV质量ET/RT组从149±28增加到155±31 g（P = 0.408），单纯ET组从144±36增加到149±42 g（P = 0.227）；EF在ET/RT组从49.1±12.3增加到49.3±12.0%（P = 0.959），单纯ET组从51.5±13.1增加到54.1%（P = 0.463）。两组的峰值VO2和肌肉力量均显著增加，但组间无差异。
急性心肌梗死后，强度高达一次最大重复量60%的RT不会比单纯ET导致更明显的LV扩张。3个月的ET/RT联合训练或单纯ET训练均可显著提高峰值VO2和肌肉力量。
