Angadi Siddhartha S, Jarrett Catherine L, Sherif Moustafa, Gaesser Glenn A, Mookadam Farouk
School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ, USA.
Department of Cardiovascular Diseases, Mayo Clinic Arizona, Scottsdale, AZ, USA.
ESC Heart Fail. 2017 Aug;4(3):356-359. doi: 10.1002/ehf2.12149. Epub 2017 Mar 16.
High-intensity interval training (HIIT) improves peak oxygen uptake and left ventricular diastology in patients with heart failure with preserved ejection fraction (HFpEF). However, its effects on myocardial strain in HFpEF remain unknown. We explored the effects of HIIT and moderate-intensity aerobic continuous training (MI-ACT) on left and right ventricular strain parameters in patients with HFpEF. Furthermore, we explored their relationship with peak oxygen uptake (VO ).
Fifteen patients with HFpEF (age = 70 ± 8.3 years) were randomized to either: (i) HIIT (4 × 4 min, 85-90% peak heart rate, interspersed with 3 min of active recovery; n = 9) or (ii) MI-ACT (30 min at 70% peak heart rate; n = 6). Patients were trained 3 days/week for 4 weeks and underwent VO testing and 2D echocardiography at baseline and after completion of the 12 sessions of supervised exercise training. Left ventricular (LV) and right ventricular (RV) average global peak systolic longitudinal strain (GLS) and peak systolic longitudinal strain rate (GSR) were quantified. Paired t-tests were used to examine within-group differences and unpaired t-tests used for between-group differences (α = 0.05). Right ventricular average global peak systolic longitudinal strain improved significantly in the HIIT group after training (pre = -18.4 ± 3.2%, post = -21.4 ± 1.7%; P = 0.02) while RV-GSR, LV-GLS, and LV-GSR did not (P > 0.2). No significant improvements were observed following MI-ACT. No significant between-group differences were observed for any strain measure. ΔLV-GLS and ΔRV-GLS were modestly correlated with ΔVO (r = -0.48 and r = -0.45; P = 0.1, respectively).
In patients with HFpEF, 4 weeks of HIIT significantly improved RV-GLS.
高强度间歇训练（HIIT）可改善射血分数保留的心力衰竭（HFpEF）患者的峰值摄氧量和左心室舒张功能。然而，其对HFpEF患者心肌应变的影响尚不清楚。我们探讨了HIIT和中等强度有氧持续训练（MI-ACT）对HFpEF患者左、右心室应变参数的影响。此外，我们还探讨了它们与峰值摄氧量（VO）的关系。
15例HFpEF患者（年龄=70±8.3岁）被随机分为：（i）HIIT组（4×4分钟，心率峰值的85-90%，穿插3分钟主动恢复；n=9）或（ii）MI-ACT组（心率峰值的70%持续30分钟；n=6）。患者每周训练3天，共4周，并在基线和完成12节有监督的运动训练后进行VO测试和二维超声心动图检查。对左心室（LV）和右心室（RV）的平均整体峰值收缩期纵向应变（GLS）和峰值收缩期纵向应变率（GSR）进行量化。采用配对t检验检查组内差异，采用非配对t检验检查组间差异（α=0.05）。训练后，HIIT组右心室平均整体峰值收缩期纵向应变显著改善（训练前=-18.4±3.2%，训练后=-21.4±1.7%；P=0.02），而RV-GSR、LV-GLS和LV-GSR未改善（P>0.2）。MI-ACT组训练后未观察到显著改善。任何应变测量的组间差异均无统计学意义。ΔLV-GLS和ΔRV-GLS与ΔVO呈中度相关（r=-0.48和r=-0.45；P分别为0.1）。
在HFpEF患者中，4周的HIIT显著改善了RV-GLS。
