Taya Masanobu, Amiya Eisuke, Hatano Masaru, Maki Hisataka, Nitta Daisuke, Saito Akihito, Tsuji Masaki, Hosoya Yumiko, Minatsuki Shun, Nakayama Atsuko, Fujiwara Takayuki, Konishi Yuto, Yokota Kazuhiko, Watanabe Masafumi, Morita Hiroyuki, Haga Nobuhiko, Komuro Issei
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Department of Rehabilitation, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Heart Vessels. 2018 Jul;33(7):752-759. doi: 10.1007/s00380-018-1120-x. Epub 2018 Jan 15.
This study investigated the effectiveness and safety of interval training during in-hospital treatment of patients with advanced heart failure. Twenty-four consecutive patients with advanced symptomatic heart failure who were referred for cardiac transplant evaluation were recruited. After performing aerobic exercise for approximate intensity, high-intensity interval training (HIIT) was performed. The protocol consisted of 3 or 4 sessions of 1-min high-intensity exercise aimed at 80% of peak VO or 80% heart rate reserve, followed by 4-min recovery periods of low intensity. In addition to the necessary laboratory data, hand grip strength and knee extensor strength were evaluated at the start of exercise training and both at the start and the end of HIIT. Knee extensor strength was standardized by body weight. The BNP level at the start of exercise training was 432 (812) pg/mL and it significantly decreased to 254 (400) pg/mL (p < 0.001) at the end of HIIT. Hand grip strength did not change during course. By contrast, knee extensor strength significantly increased during HIIT [4.42 ± 1.43 → 5.28 ± 1.45 N/kg, p < 0.001], whereas the improvement of knee extensor strength was not significant from the start of exercise training to the start of HIIT. In addition, the change in knee extensor strength during HIIT was significantly associated with the hemoglobin A1c level at the start of exercise (R = - 0.55; p = 0.015). HIIT has a positive impact on skeletal muscle strength among in-hospital patients with advanced heart failure.
本研究调查了晚期心力衰竭患者住院治疗期间进行间歇训练的有效性和安全性。招募了24例因心脏移植评估而转诊的晚期症状性心力衰竭连续患者。在进行了近似强度的有氧运动后,进行了高强度间歇训练(HIIT)。该方案包括3或4组1分钟的高强度运动,目标是达到峰值VO₂的80%或心率储备的80%,随后是4分钟的低强度恢复期。除了必要的实验室数据外,在运动训练开始时以及HIIT开始和结束时评估了握力和膝伸肌力量。膝伸肌力量按体重进行标准化。运动训练开始时的脑钠肽(BNP)水平为432(812)pg/mL,在HIIT结束时显著降至254(400)pg/mL(p<0.001)。在整个过程中握力没有变化。相比之下,在HIIT期间膝伸肌力量显著增加[4.42±1.43→5.28±1.45N/kg,p<0.001],而从运动训练开始到HIIT开始膝伸肌力量的改善并不显著。此外,HIIT期间膝伸肌力量的变化与运动开始时的糖化血红蛋白水平显著相关(R=-0.55;p=0.015)。HIIT对住院晚期心力衰竭患者的骨骼肌力量有积极影响。