VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia; Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart, Rome, Italy.
Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois; Total Cardiology Research Network, Calgary, Alberta, Canada.
J Am Coll Cardiol. 2019 May 7;73(17):2209-2225. doi: 10.1016/j.jacc.2019.01.072.
Exercise intolerance is the cardinal symptom of heart failure (HF) and is of crucial relevance, because it is associated with a poor quality of life and increased mortality. While impaired cardiac reserve is considered to be central in HF, reduced exercise and functional capacity are the result of key patient characteristics and multisystem dysfunction, including aging, impaired pulmonary reserve, as well as peripheral and respiratory skeletal muscle dysfunction. We herein review the different modalities to quantify exercise intolerance, the pathophysiology of HF, and comorbid conditions as they lead to reductions in exercise and functional capacity, highlighting the fact that distinct causes may coexist and variably contribute to exercise intolerance in patients with HF.
运动不耐受是心力衰竭（HF）的主要症状，具有至关重要的意义，因为它与生活质量差和死亡率增加有关。虽然心脏储备受损被认为是 HF 的核心，但运动和功能能力的降低是关键患者特征和多系统功能障碍的结果，包括衰老、肺储备受损以及周围和呼吸骨骼肌肉功能障碍。本文综述了定量评估运动不耐受的不同方法、HF 的病理生理学以及合并症，因为它们会导致运动和功能能力降低，突出了这样一个事实，即不同的原因可能同时存在，并以不同的方式导致 HF 患者的运动不耐受。
