Department of Cardiology, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Belgium.
Ther Adv Chronic Dis. 2013 May;4(3):105-17. doi: 10.1177/2040622313480382.
The syndrome of heart failure (HF) is a growing epidemic that causes a significant socio-economic burden. Despite considerable progress in the management of patients with HF, mortality and morbidity remain a major healthcare concern and frequent hospital admissions jeopardize daily life and social activities. Exercise training is an important adjunct nonpharmacological treatment modality for patients with HF that has proven positive effects on mortality, morbidity, exercise capacity and quality of life. Different training modalities are available to target the problems with which HF patients are faced. It is essential to tailor the prescribed exercise regimen, so that both efficiency and safety are guaranteed. Electrical implanted devices and mechanical support should not exclude patients from exercise training; however, particular precautions and a specialized approach are advised. At least 50% of patients with HF, older than 65 years of age, present with HF with preserved ejection fraction (HFPEF). Although the study populations included in studies evaluating the effect of exercise training in this population are small, the results are promising and seem to support the idea that exercise training is beneficial for HFPEF patients. Both the short- and especially long-term adherence to exercise training remain a major challenge that can only be tackled by a multidisciplinary approach. Efforts should be directed towards closing the gap between recommendations and the actual implementation of training programmes.
心力衰竭（HF）综合征是一种日益严重的流行疾病，给社会经济带来了巨大负担。尽管 HF 患者的管理取得了相当大的进展，但死亡率和发病率仍然是医疗保健的主要关注点，频繁的住院治疗危及日常生活和社会活动。运动训练是 HF 患者的一种重要非药物治疗辅助手段，已被证明对死亡率、发病率、运动能力和生活质量有积极影响。有多种训练方式可用于针对 HF 患者面临的问题。重要的是要调整规定的运动方案，以确保效率和安全性。植入式电子设备和机械支持不应使患者无法进行运动训练；然而，建议采取特殊的预防措施和专门的方法。至少有 50%的年龄大于 65 岁的 HF 患者存在射血分数保留的心力衰竭（HFPEF）。尽管评估该人群运动训练效果的研究中纳入的研究人群较小，但结果令人鼓舞，似乎支持运动训练对 HFPEF 患者有益的观点。短期和尤其是长期坚持运动训练仍然是一个重大挑战，只能通过多学科方法来解决。应努力缩小建议与实际实施训练计划之间的差距。
