Department of Medicine, Henry Ford Hospital, 6525 Second Avenue, Detroit, MI 48202, USA.
Heart Fail Rev. 2010 Nov;15(6):523-30. doi: 10.1007/s10741-009-9157-7.
Initial research established the feasibility of exercise training in patients with heart failure, as well as associated physiological benefits. This review summarizes the findings from over two dozen single-site studies that address the effect of exercise training on exercise capacity and cardiovascular and peripheral function. In addition, it incorporates the results from two meta-analyses and a recently completed multi-center trial, all of which studied the effects of exercise training on clinical outcomes. The major conclusions from these studies are that exercise training is safe; improves health status and exercise capacity; helps attenuate much of the abnormal pathophysiology that develops with heart failure; and yields a modest reduction in clinical events. The magnitude of the clinical benefits appears related to the volume of exercise completed. Future research is needed to identify which patient subgroups might benefit the most from exercise training, the optimal exercise dose or load needed to lessen disease-related symptoms and maximize clinical benefit, and the effects of exercise training in patients with heart failure and preserved left ventricular systolic function.
最初的研究证实了心力衰竭患者进行运动训练的可行性，以及相关的生理益处。这篇综述总结了二十多个单中心研究的结果，这些研究探讨了运动训练对运动能力以及心血管和外周功能的影响。此外，它还纳入了两项荟萃分析和一项最近完成的多中心试验的结果，这些研究都探讨了运动训练对临床结局的影响。这些研究的主要结论是，运动训练是安全的；可改善健康状况和运动能力；有助于减轻心力衰竭患者出现的许多异常病理生理学改变；并适度降低临床事件发生率。临床获益的程度似乎与完成的运动量有关。未来的研究需要确定哪些患者亚组可能从运动训练中获益最多，减轻与疾病相关的症状和最大限度地提高临床获益所需的最佳运动剂量或负荷，以及运动训练对心力衰竭和保留左心室收缩功能患者的影响。
