School of Science and Technology, University of New England, Armidale, NSW 2351, Australia.
School of Science and Technology, University of New England, Armidale, NSW 2351, Australia.
Int J Cardiol. 2014 Jan 15;171(1):62-5. doi: 10.1016/j.ijcard.2013.11.045. Epub 2013 Nov 22.
Intuitively higher exercise program volume may be the primary stimulus for physical adaptation. We sought to establish if aerobic exercise training program characteristics produced different effect sizes for change in cardiorespiratory fitness in heart failure patients.
We conducted a MEDLINE search (1966 to 2012), for exercise based rehabilitation trials in heart failure, using the search terms 'exercise training, left ventricular dysfunction, peak VO2, cardio-myopathy and systolic heart dysfunction'. Forty seven studies were included, producing 54 intervention groups; 3 (6%) were high-, 29 (54%) vigorous-, 20 (37%) moderate- and 2 (3%) low- intensity groups, providing a total of 2285 exercising subjects and 2098 control subjects, totaling 4383 participants.
Peak VO2 increased by a mean difference of 3.3 ml kg(-1)min(-1) [95% CI 0.53 to 6.13, p=0.02] with high intensity training in exercise groups versus control, equating to a 23% improvement from baseline. The corresponding data for vigorous, moderate and low intensity were 8%, 13%; and 7% respectively. Weekly exercise energy expenditure >460 kcal was associated with a mean difference in peak VO2 of 2.6 ml kg(-1)min(-1) [95% CI 1.88 to 3.28, p<0.00001].
Our data suggest that high-intensity exercise, achieving at least 460 kcal weekly energy expenditure may elicit the greatest changes in cardiorespiratory fitness.
直观地说，更高的运动项目量可能是身体适应的主要刺激因素。我们试图确定有氧运动训练计划的特点是否会对心力衰竭患者的心肺适应能力的变化产生不同的效果大小。
我们进行了 MEDLINE 搜索（1966 年至 2012 年），使用搜索词“运动训练、左心室功能障碍、峰值 VO2、心肌病和收缩性心力衰竭”，寻找心力衰竭的基于运动的康复试验。共纳入 47 项研究，产生 54 个干预组；3 个（6%）为高强度组，29 个（54%）为剧烈运动组，20 个（37%）为中等强度组，2 个（3%）为低强度组，共 2285 名运动受试者和 2098 名对照组，共有 4383 名参与者。
与对照组相比，高强度训练组的峰值 VO2 平均增加了 3.3ml·kg(-1)·min(-1) [95%CI 0.53 至 6.13，p=0.02]，相当于基线的 23%的改善。剧烈运动、中等强度和低强度的相应数据分别为 8%、13%和 7%。每周运动能量消耗>460kcal 与峰值 VO2 的平均差异为 2.6ml·kg(-1)·min(-1) [95%CI 1.88 至 3.28，p<0.00001]。
我们的数据表明，高强度运动，每周至少达到 460kcal 的能量消耗，可能会引起心肺适应能力的最大变化。
