Kennel Peter J, Mancini Donna M, Schulze P Christian
Center for Advanced Cardiac Care, Division of Cardiology, New York-Presbyterian Hospital and Columbia University Medical Center, New York, USA.
Compr Physiol. 2015 Sep 20;5(4):1947-69. doi: 10.1002/cphy.c110003.
Peak exercise performance in healthy man is limited not only by pulmonary or skeletal muscle function but also by cardiac function. Thus, abnormalities in cardiac function will have a major impact on exercise performance. Many cardiac diseases affect exercise performance and indeed for some cardiac conditions such as atherosclerotic heart disease, exercise testing is frequently used not only to measure functional capacity but also to make a diagnosis of heart disease, evaluate the efficacy of treatment, and predict prognosis. Early in the course of cardiac diseases, exercise performance will be minimally affected but with disease progression impairment in exercise capacity will become apparent. Ejection fraction, that is, the percent of blood volume ejected with each cardiac cycle is often used as a measure of cardiac performance but frequently there is a dissociation between the ejection fraction and exercise capacity in patients with heart disease. How abnormalities in cardiac function impacts the muscles, vasculature, and lungs to impact exercise performance will here be reviewed. The focus of this work will be on patients with systolic heart failure as the incidence and prevalence of heart failure is reaching epidemic proportions and heart failure is the end result of many other chronic cardiac diseases. The prognostic role of exercise and benefits of exercise training will also be discussed.
健康男性的运动峰值表现不仅受肺功能或骨骼肌功能限制，还受心脏功能限制。因此，心脏功能异常将对运动表现产生重大影响。许多心脏疾病会影响运动表现，实际上对于某些心脏疾病，如动脉粥样硬化性心脏病，运动测试不仅经常用于测量功能能力，还用于诊断心脏病、评估治疗效果和预测预后。在心脏疾病病程早期，运动表现受影响较小，但随着疾病进展，运动能力受损将变得明显。射血分数，即每个心动周期射出的血量百分比常被用作心脏功能的指标，但心脏病患者的射血分数与运动能力之间常常脱节。本文将综述心脏功能异常如何影响肌肉、血管系统和肺，进而影响运动表现。这项工作的重点将是收缩性心力衰竭患者，因为心力衰竭的发病率和患病率正达到流行程度，且心力衰竭是许多其他慢性心脏疾病的最终结果。还将讨论运动的预后作用和运动训练的益处。
