1(st) Critical Care Department, Cardiopulmonary Exercise Testing and Rehabilitation Laboratory, Evgenidio Hospital, NKUA, Athens, Greece.
J Card Fail. 2011 Jul;17(7):585-91. doi: 10.1016/j.cardfail.2011.02.009. Epub 2011 Apr 22.
Exercise training confers beneficial effects on vascular reactivity in patients with chronic heart failure (CHF). This randomized study compares the effects of interval cycle training combined with strength training versus interval training alone on vascular reactivity in CHF patients.
Twenty-eight consecutive stable CHF patients (23 males, 53 ± 10 years, 28.4 ± 4.1 kg/m(2), left ventricular ejection fraction of 37 ± 12%) were randomly assigned to 3 times' weekly training sessions for 3 months, consisting of a) 40 minutes of interval cycle training (n = 14), versus b) 20 minutes of similar interval training plus 20 minutes of strength training of the quadriceps, hamstrings, muscles of the shoulder and biceps brachialis (n = 14). The work/recovery ratio of each session was 30/60 seconds. The intensity of interval training was set at 50% of the peak workload achieved at the steep ramp test (consisted of a 25-Watt increase on a cycle ergometer every 10 seconds until exhaustion). All patients underwent maximal, symptom-limited cardiopulmonary exercise testing and ultrasound evaluation of vascular reactivity by flow-mediated vasodilation (FMD) before and after the program.
A significant improvement in FMD was observed in the combined training group (P = 0.002), in contrast to the interval training alone group (P = NS); the improvement was significantly greater in the combined training than in the interval training alone group (P < .05). Peak oxygen uptake increased significantly and similarly in both groups, in the interval training group (P = .03), and in the combined training group (P = .006). No significant correlation was found between FMD improvement and cardiopulmonary exercise parameters.
A combined high-intensity, interval cycle exercise with strength training induces a greater beneficial effect on vascular reactivity rather than interval exercise training alone in CHF patients.
运动训练对慢性心力衰竭（CHF）患者的血管反应性有益。这项随机研究比较了间歇循环训练与间歇训练联合力量训练对 CHF 患者血管反应性的影响。
28 例连续稳定的 CHF 患者（男 23 例，年龄 53±10 岁，体重指数 28.4±4.1kg/m2，左心室射血分数 37±12%）随机分为 3 组，每周训练 3 次，持续 3 个月，包括：a）40 分钟的间歇循环训练（n=14），b）20 分钟类似的间歇训练加 20 分钟股四头肌、腘绳肌、肩部和肱二头肌的力量训练（n=14）。每次训练的工作/恢复比为 30/60 秒。间歇训练的强度设定为斜率 ramp 试验达到的峰值工作负荷的 50%（在自行车测力计上每 10 秒增加 25 瓦，直到力竭）。所有患者在试验前后均进行最大、症状限制心肺运动试验和超声评价血管反应性（血流介导的血管舒张[FMD]）。
与单独间歇训练组相比（P=NS），联合训练组的 FMD 显著改善（P=0.002）；联合训练组的改善明显大于单独间歇训练组（P<0.05）。间歇训练组（P=0.03）和联合训练组（P=0.006）的峰值摄氧量均显著增加且相似。FMD 改善与心肺运动参数之间无显著相关性。
与单独间歇训练相比，高强度间歇循环运动联合力量训练对 CHF 患者的血管反应性具有更大的有益作用。
