Department of Cardiology, Peking University People's Hospital, Beijing, 100044, People's Republic of China.
Adv Exp Med Biol. 2017;1000:31-49. doi: 10.1007/978-981-10-4304-8_3.
People with heart failure experience marked reduction in their exercise capacity which has detrimental effects on their activities of daily living, health-related quality of life, and ultimately their hospital ad-mission rate and mortality. Numerous cardiac rehabilitation studies have demonstrated functional benefits, improvement in quality of life and clinical outcomes from exercise training in patients with HFrEF. Based on evidences, the American College of Cardiology/American Heart Association, European Society of Cardiology, and National Institute for Health and Care Excellence(NICE) consistently recommend exercise-based cardiac rehabilitation(CR) as an effective and safe adjunct for patients with stable class II to III heart failure (HF) who do not have advanced arrhythmias and who do not have other limitations to exercise. This recommendation applies to patients with HFrEF as well as to patients with HFpEF besides patients with class IV HF, although the data are not as robust for patients with HFpEF. In this article, the clinical evidence on effects of exercise for HFrEF and HFpEF as well as end-stage heart failure were separately reviewed.
心力衰竭患者的运动能力显著下降，这对他们的日常活动、健康相关生活质量产生不利影响，并最终导致他们的住院率和死亡率上升。大量心脏康复研究表明，HFrEF 患者进行运动训练具有功能获益、生活质量改善和临床结局改善。基于证据，美国心脏病学会/美国心脏协会、欧洲心脏病学会和英国国家卫生与保健优化研究所（NICE）一致推荐将基于运动的心脏康复（CR）作为稳定的 II 级至 III 级心力衰竭（HF）患者的有效和安全辅助治疗方法，这些患者没有严重心律失常，也没有其他运动限制。该建议适用于 HFrEF 患者，以及 HFpEF 患者，尽管对于 HFpEF 患者的数据不如 HFrEF 患者那么可靠。本文分别回顾了运动对 HFrEF 和 HFpEF 以及终末期心力衰竭的临床证据。
