Santoso Anwar, Purwowiyoto Sidhi Laksono, Purwowiyoto Budhi Setianto, Soesanto Amiliana Mardiana
Department of Cardiology - Vascular Medicine, Faculty of Medicine - Universitas Indonesia, National Cardiovascular Centre - Harapan Kita Hospital, Jakarta, Indonesia.
Department of Cardiology -Vascular Medicine, Pasar Rebo Hospital, Jakarta Timur, Indonesia.
Int J Angiol. 2019 Mar;28(1):44-49. doi: 10.1055/s-0038-1676836. Epub 2019 Jan 8.
Exercise improves morbidity, fatality rate, and quality of life in heart failure with low ejection fraction, but fewer data available in heart failure with preserved ejection fraction (HFPEF). The purpose of this study is to test the hypothesis that exercise training might improve the longitudinal intrinsic left ventricular (LV) function in HFPEF patients. This quasi-experimental study had recruited 30 patients with HFPEF. Exercise training program had been performed for a month with a total of 20 times exercise sessions and evaluated every 2 weeks. Echocardiography was performed before sessions, second week and fourth week of exercise training. Six-minute walk tests (6MWTs) and quality-of-life variables using Minnesota living with HF scoring and the 5-item World Health Organization Well-Being Index scoring were measured before and after exercise as well. Left ventricular filling pressure, represented by the ratio of early diastolic mitral flow velocity/early diastolic annular velocity and left atrial volume index, improved during exercise. The longitudinal intrinsic LV function, represented by four-chamber longitudinal strain, augmented during exercise ( < 0.001). Aerobic capacity, measured by 6MWT, increased significantly ( = 0.001). Quality of life improved significantly during exercise ( < 0.001). Exercise training was suggested to improve the longitudinal intrinsic LV function and quality of life in HFPEF. Clinical Trial Registration: ACTRN12614001042639.
运动可改善射血分数降低的心力衰竭患者的发病率、死亡率和生活质量，但关于射血分数保留的心力衰竭（HFpEF）患者的数据较少。本研究的目的是检验运动训练可能改善HFpEF患者左心室（LV）纵向固有功能这一假设。这项准实验研究招募了30例HFpEF患者。运动训练计划进行了一个月，共20次训练课程，每2周进行一次评估。在训练前、运动训练的第二周和第四周进行超声心动图检查。还在运动前后测量了六分钟步行试验（6MWT）以及使用明尼苏达心力衰竭生活评分和世界卫生组织5项幸福指数评分的生活质量变量。以舒张早期二尖瓣血流速度/舒张早期环速度比值和左心房容积指数表示的左心室充盈压在运动期间有所改善。以四腔纵向应变表示的纵向固有LV功能在运动期间增强（<0.001）。通过6MWT测量的有氧运动能力显著增加（=0.001）。运动期间生活质量显著改善（<0.001）。建议运动训练可改善HFpEF患者的纵向固有LV功能和生活质量。临床试验注册：ACTRN12614001042639。
