Laboratório de Insuficiencia Cardíaca e Transplante do Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da USP (InCor HC-FMUSP), São Paulo, Brazil.
Cardiol J. 2011;18(1):39-46.
Studies have investigated the influence of neuromuscular electrostimulation on the exercise/muscle capacity of patients with heart failure (HF), but the hemodynamic overload has never been investigated. The aim of our study was to evaluate the heart rate (HR), systolic and diastolic blood pressures in one session of strength exercises with and without neuromuscular electrostimulation (quadriceps) in HF patients and in healthy subjects.
Ten (50% male) HF patients and healthy subjects performed three sets of eight repetitions with and without neuromuscular electrostimulation randomly, with one week between sessions. Throughout, electromyography was performed to guarantee the electrostimulation was effective. The hemodynamic variables were measured at rest, again immediately after the end of each set of exercises, and during the recovery period.
Systolic and diastolic blood pressures did not change during each set of exercises among either the HF patients or the controls. Without electrostimulation: among the controls, the HR corresponding to the first (85 ± 13 bpm, p = 0.002), second (84 ± 10 bpm, p < 0.001), third (89 ± 17, p < 0.001) sets and recuperation (83 ± 16 bpm, p = 0.012) were different compared to the resting HR (77 bpm). Moreover, the recuperation was different to the third set (0.018). Among HF patients, the HR corresponding to the first (84 ± 9 bpm, p = 0.041) and third (84 ± 10 bpm, p = 0.036) sets were different compared to the resting HR (80 ± 7 bpm), but this increase of 4 bpm is clinically irrelevant to HF. With electrostimulation: among the controls, the HR corresponding to the third set (84 ± 9 bpm) was different compared to the resting HR (80 ± 7 bmp, p = 0.016). Among HF patients, there were no statistical differences between the sets. The procedure was well tolerated and no subjects reported muscle pain after 24 hours.
One session of strength exercises with and without neuromuscular electrostimulation does not promote a hemodynamic overload in HF patients.
已有研究探讨了神经肌肉电刺激对心力衰竭（HF）患者运动/肌肉能力的影响，但从未研究过血液动力学过载。我们的研究目的是评估 HF 患者和健康受试者在一次力量训练中使用和不使用神经肌肉电刺激（股四头肌）时的心率（HR）、收缩压和舒张压。
10 名（50%为男性）HF 患者和健康受试者随机进行三组 8 次重复的力量训练，每组之间间隔一周。整个过程中，进行肌电图以保证电刺激有效。在休息时、每组运动结束后立即以及恢复期测量血流动力学变量。
在每组运动中，HF 患者和对照组的收缩压和舒张压均无变化。不使用电刺激：在对照组中，第一组（85±13bpm，p=0.002）、第二组（84±10bpm，p<0.001）、第三组（89±17bpm，p<0.001）和恢复期（83±16bpm，p=0.012）的 HR 与静息 HR（77bpm）不同。此外，恢复期与第三组不同（0.018）。在 HF 患者中，第一组（84±9bpm，p=0.041）和第三组（84±10bpm，p=0.036）的 HR 与静息 HR（80±7bpm）不同，但这种 4bpm 的增加与 HF 无关。使用电刺激：在对照组中，第三组（84±9bpm）的 HR 与静息 HR（80±7bpm，p=0.016）不同。在 HF 患者中，各组之间没有统计学差异。该过程耐受性良好，没有受试者在 24 小时后报告肌肉疼痛。
HF 患者一次使用和不使用神经肌肉电刺激的力量训练不会引起血液动力学过载。
