Kondamudi Nitin, Haykowsky Mark, Forman Daniel E, Berry Jarett D, Pandey Ambarish
Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States.
College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, United States.
Prog Cardiovasc Dis. 2017 Jun-Jul;60(1):115-120. doi: 10.1016/j.pcad.2017.07.001. Epub 2017 Jul 3.
Heart failure (HF) results in high healthcare costs and burdens for the United States in respects to hospitalizations, therapies, and associated disability. The relative proportion of HF with preserved ejection fraction (HFpEF) compared with HF with reduced ejection fraction (HFrEF) is on the rise; HFpEF has already become the dominant form of HF and it continues to increase. The serious implications of these trends are compounded by a dearth of effective HFpEF therapies. While low physical activity, low cardiorespiratory fitness (CRF), and obesity, are risk factors for HF in general, they particularly predispose to HFpEF. Thus, weight loss and exercise that leads to improved CRF may constitute important opportunities for effective intervention. In this review, we discuss the interplay between physical inactivity, CRF, and obesity in the development of HF, particularly HFpEF, and highlight the current evidence on weight loss and exercise as preventive and therapeutic opportunities.
心力衰竭(HF)给美国带来了高昂的医疗成本以及在住院治疗、疗法和相关残疾方面的负担。与射血分数降低的心力衰竭(HFrEF)相比,射血分数保留的心力衰竭(HFpEF)的相对比例正在上升;HFpEF已经成为心力衰竭的主要形式,并且还在持续增加。有效治疗HFpEF的方法匮乏,使这些趋势的严重影响更加复杂。虽然身体活动不足、心肺适能(CRF)低下和肥胖通常是心力衰竭的危险因素,但它们尤其易引发HFpEF。因此,体重减轻和能提高CRF的运动可能构成有效干预的重要机会。在本综述中,我们讨论了身体活动不足、CRF和肥胖在心力衰竭尤其是HFpEF发生过程中的相互作用,并强调了目前关于体重减轻和运动作为预防及治疗机会的证据。