Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Pisana, Rome, Italy.
Int J Cardiol. 2013 Sep 10;167(6):2561-5. doi: 10.1016/j.ijcard.2012.06.057. Epub 2012 Jul 4.
The best format of exercise training in patients with chronic heart failure (CHF) is controversial. We tested the hypothesis that aerobic continuous training (ACT) and aerobic interval training (AIT) induce similar effects on functional capacity, central hemodynamics and metabolic profile in patients with postinfarction CHF provided that the training load is equated by an individually-tailored volume/intensity dose of exercise.
Twenty patients with postinfarction CHF under optimal medical treatment were randomized to ACT or AIT for 12 weeks. Exercise training consisted in individualized loads prescribed according to the Training Impulses (TRIMPi) method, which was determined using the individual HR and lactate profiling obtained during a treadmill test at baseline.
Peak VO2 increased significantly by 22% with both ACT and AIT, without differences between the two training programs. Changes in anaerobic threshold and VE/VCO2 slope were not significantly different between ACT and AIT. Resting HR significantly decreased with both exercise modes. Resting cardiac output and stroke volume, left ventricular diastolic dimension and ejection fraction did not change from baseline with both exercise modes. Lipid profile and glucose metabolism were not substantially altered by ACT and AIT.
ACT and AIT both induce significant improvement in aerobic capacity in patients with postinfarction CHF, without significant differences between the two training modes, provided that patients are trained at the same, individually tailored, dose of exercise. The TRIMPi method might represent a step forward in the individualization of an aerobic training tailored to the patient's clinical and functional status within cardiac rehabilitation programs.
慢性心力衰竭（CHF）患者最佳的运动训练形式仍存在争议。我们假设，在通过个体化的运动量/强度剂量的运动来平衡训练负荷的情况下，有氧连续训练（ACT）和有氧间歇训练（AIT）在改善心功能、中心血液动力学和代谢特征方面具有相似的效果。
20 名在最佳药物治疗下患有梗死后 CHF 的患者被随机分为 ACT 或 AIT 组，进行 12 周的治疗。运动训练采用个体化的负荷，根据训练冲动（TRIMPi）方法进行设定，该方法通过在基线时进行跑步机测试时获得的个体 HR 和乳酸廓清来确定。
ACT 和 AIT 均可使峰值 VO2 显著增加 22%，两种训练方案之间无差异。ACT 和 AIT 对无氧阈和 VE/VCO2 斜率的改变无显著差异。两种运动方式均可使静息心率显著降低。两种运动方式均未使静息心输出量、每搏量、左心室舒张末期直径和射血分数发生变化。ACT 和 AIT 并未明显改变血脂谱和葡萄糖代谢。
ACT 和 AIT 均可使梗死后 CHF 患者的有氧能力显著改善，两种训练模式之间无显著差异，前提是患者以相同的个体化运动量进行训练。TRIMPi 方法可能是在心脏康复计划中为患者的临床和功能状态量身定制个体化有氧训练方面迈出的一步。
