Tzanis Georgios, Philippou Anastassios, Karatzanos Eleftherios, Dimopoulos Stavros, Kaldara Elisavet, Nana Emmeleia, Pitsolis Theodoros, Rontogianni Dimitra, Koutsilieris Michael, Nanas Serafim
1st Critical Care Medicine Department, Cardiopulmonary Exercise Testing and Rehabilitation Laboratory, "Evgenidio Hospital," National & Kapodistrian University of Athens, Greece.
Department of Experimental Physiology, Medical School, National and Kapodistrian University of Athens, Greece.
J Card Fail. 2017 Jan;23(1):36-46. doi: 10.1016/j.cardfail.2016.06.007. Epub 2016 Jun 17.
It remains controversial which type of exercise elicits optimum adaptations on skeletal myopathy of heart failure (HF). Our aim was to evaluate the effect of high-intensity interval training (HIIT), with or without the addition of strength training, on skeletal muscle of HF patients.
Thirteen male HF patients (age 51 ± 13 years, body mass index 27 ± 4 kg/m) participated in either an HIIT (AER) or an HIIT combined with strength training (COM) 3-month program. Biopsy samples were obtained from the vastus lateralis. Analyses were performed on muscle fiber type, cross-section area (CSA), capillary density, and mRNA expression of insulin-like growth factor (IGF) 1 isoforms (ie, IGF-1Ea, IGF-1Eb, IGF-1Ec), type-1 receptor (IGF-1R), and binding protein 3 (IGFBP-3). Increased expression of IGF-1Ea, IGF-1Eb, IGF-1Ec, and IGFBP-3 transcripts was found (1.7 ± 0.8, 1.5 ± 0.8, 2.0 ± 1.32.4 ± 1.4 fold changes, respectively; P < .05). Type I fibers increased by 21% (42 ± 10% to 51 ± 7%; P < .001) and capillary/fiber ratio increased by 24% (1.27 ± 0.22 to 1.57 ± 0.41; P = .005) in both groups as a whole. Fibers' mean CSA increased by 10% in total, but the increase in type I fibers' CSA was greater after AER than COM (15% vs 6%; P < .05). The increased CSA correlated with the increased expression of IGF-1Ea and IGF-1Εb.
HIIT reverses skeletal myopathy of HF patients, with the adaptive responses of the IGF-1 bioregulation system possibly contributing to these effects. AER program seemed to be superior to COM to induce muscle hypertrophy.
对于哪种类型的运动能引起心力衰竭(HF)患者骨骼肌病变的最佳适应性变化仍存在争议。我们的目的是评估高强度间歇训练(HIIT),无论是否添加力量训练,对HF患者骨骼肌的影响。
13名男性HF患者(年龄51±13岁,体重指数27±4kg/m²)参加了为期3个月的HIIT(AER)或HIIT联合力量训练(COM)项目。从股外侧肌获取活检样本。对肌纤维类型、横截面积(CSA)、毛细血管密度以及胰岛素样生长因子(IGF)1亚型(即IGF-1Ea、IGF-1Eb、IGF-1Ec)、1型受体(IGF-1R)和结合蛋白3(IGFBP-3)的mRNA表达进行分析。发现IGF-1Ea、IGF-1Eb、IGF-1Ec和IGFBP-3转录本表达增加(分别为1.7±0.8、1.5±0.8、2.0±1.3、2.4±1.4倍变化;P<0.05)。总体而言,两组的I型纤维增加了21%(从42±10%增至51±7%;P<0.001),毛细血管/纤维比率增加了24%(从1.27±0.22增至1.57±0.41;P=0.005)。纤维的平均CSA总体增加了10%,但AER组I型纤维CSA的增加幅度大于COM组(15%对6%;P<0.05)。CSA的增加与IGF-1Ea和IGF-1Εb表达的增加相关。
HIIT可逆转HF患者的骨骼肌病变,IGF-1生物调节系统的适应性反应可能促成了这些效应。AER方案在诱导肌肉肥大方面似乎优于COM方案。