Rustad Lene A, Nytrøen Kari, Amundsen Brage H, Gullestad Lars, Aakhus Svend
Department of Cardiology, Oslo University Hospital HF, Rikshospitalet, Norway.
Eur J Prev Cardiol. 2014 Feb;21(2):181-91. doi: 10.1177/2047487312469477. Epub 2012 Nov 26.
Heart transplant recipients have lower exercise capacity and impaired cardiac function compared with the normal population. High-intensity interval training (HIIT) improves exercise capacity and cardiac function in patients with heart failure and hypertension, but the effect on cardiac function in stable heart transplant recipients is not known. Thus, we investigated whether HIIT improved cardiac function and exercise capacity in stable heart transplant recipients by use of comprehensive rest- and exercise-echocardiography and cardiopulmonary exercise testing.
Fifty-two clinically stable heart transplant recipients were randomised either to HIIT (4 × 4 minutes at 85-95% of peak heart rate three times per week for eight weeks) or to control. Three such eight-week periods were distributed throughout one year. Echocardiography (rest and submaximal exercise) and cardiopulmonary exercise testing were performed at baseline and follow-up.
One year of HIIT increased VO 2peak from 27.7 ± 5.5 at baseline to 30.9 ± 5.0 ml/kg/min at follow-up, while the control group remained unchanged (28.5 ± 7.0 vs. 28.0 ± 6.7 ml/kg per min, p < 0.001 for difference between the groups). Systolic and diastolic left ventricular functions at rest and during exercise were generally unchanged by HIIT.
Whereas HIIT is feasible in heart transplant recipients and effectively improves exercise capacity, it does not alter cardiac systolic and diastolic function significantly. Thus, the observed augmentation in exercise capacity is best explained by extra-cardiac adaptive mechanisms.
与正常人群相比,心脏移植受者的运动能力较低且心脏功能受损。高强度间歇训练(HIIT)可改善心力衰竭和高血压患者的运动能力及心脏功能,但对稳定的心脏移植受者心脏功能的影响尚不清楚。因此,我们通过综合静息和运动超声心动图以及心肺运动测试,研究了HIIT是否能改善稳定的心脏移植受者的心脏功能和运动能力。
52名临床稳定的心脏移植受者被随机分为HIIT组(每周3次,每次4分钟,心率达到峰值心率的85 - 95%,共8周)或对照组。这样的8周周期在一年中分布为3个。在基线和随访时进行超声心动图检查(静息和次极量运动)以及心肺运动测试。
一年的HIIT使峰值摄氧量从基线时的27.7±5.5增加到随访时的30.9±5.0 ml/kg/min,而对照组保持不变(28.5±7.0 vs. 28.0±6.7 ml/kg/min,组间差异p<0.001)。HIIT对静息和运动时的左心室收缩和舒张功能总体上没有影响。
虽然HIIT在心脏移植受者中是可行的,并且能有效提高运动能力,但它不会显著改变心脏的收缩和舒张功能。因此,观察到的运动能力增强最好用心脏外的适应性机制来解释。