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高强度间歇训练对近期急性心肌梗死后心室重构的影响:一项随机训练干预的初步研究。

The impact of high-intensity interval training on ventricular remodeling in patients with a recent acute myocardial infarction-A randomized training intervention pilot study.

机构信息

Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.

Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.

出版信息

Clin Cardiol. 2019 Dec;42(12):1222-1231. doi: 10.1002/clc.23277. Epub 2019 Oct 10.

Abstract

BACKGROUND

Aerobic exercise training is associated with beneficial ventricular remodeling and an improvement in cardiac biomarkers in chronic stable heart failure. High-intensity interval training (HIIT) is a time-efficient method to improve in stable coronary heart disease patients. This pilot study aimed to compare the effect of HIIT on ventricular remodeling in patients with a recent acute myocardial infarction (AMI).

METHODS

Nineteen post-AMI patients were randomized to either HIIT (n = 9) or usual care (n = 10). A cardiopulmonary exercise test (CPET), transthoracic echocardiography, and cardiac biomarker assessment (ie, N-terminal pro B-type natriuretic peptide levels and G protein-coupled receptor kinase 2 expression) were performed before and after a 12-week training intervention. CPET parameters including oxygen uptake efficiency slope (OUES) and at the first ventilatory threshold ( VT1) were calculated. left ventricular (LV) structural and functional echocardiographic parameters including myocardial strain imaging were assessed.

RESULTS

and OUES improved solely in the HIIT group (P < .05 for group/time, respectively). There was a significant training effect for the improvement of peak work load in both groups (P < .05). O pulse and at VT1 both improved only in the HIIT group (P < .05 for time, no interaction). HIIT improved radial strain and pulsed-wave tissue Doppler imaging derived e' (P < .05 for time, no interaction). Cardiac biomarkers did not change in either group.

CONCLUSIONS

In post-AMI patients, HIIT lead to significant improvements in prognostic CPET parameters compared to usual care. HIIT was associated with favorable ventricular remodeling regarding certain echocardiographic parameters of LV function.

摘要

背景

有氧运动训练与慢性稳定心力衰竭患者有益的心室重构和心脏生物标志物改善相关。高强度间歇训练(HIIT)是改善稳定型冠心病患者的一种高效省时的方法。本研究旨在比较 HIIT 对近期急性心肌梗死(AMI)患者心室重构的影响。

方法

19 例 AMI 后患者被随机分为 HIIT 组(n=9)和常规治疗组(n=10)。在 12 周训练干预前后进行心肺运动试验(CPET)、经胸超声心动图和心脏生物标志物评估(即 N 末端 B 型利钠肽前体水平和 G 蛋白偶联受体激酶 2 表达)。计算 CPET 参数,包括摄氧量效率斜率(OUES)和第一通气阈( VT1)时的摄氧量。评估左心室(LV)结构和功能超声心动图参数,包括心肌应变成像。

结果

仅在 HIIT 组中, 和 OUES 得到改善(分别为组/时间,P<0.05)。两组的峰值工作负荷均有显著的训练效果(P<0.05)。仅在 HIIT 组中,O 脉冲和 VT1 时的摄氧量均得到改善(分别为时间,无交互作用,P<0.05)。HIIT 改善了径向应变和脉冲组织多普勒成像衍生的 e'(时间,无交互作用,P<0.05)。两组的心脏生物标志物均未发生变化。

结论

在 AMI 后患者中,与常规治疗相比,HIIT 导致预后 CPET 参数的显著改善。HIIT 与某些 LV 功能的超声心动图参数的有利心室重构相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e25/6906981/ffd9dc1612e9/CLC-42-1222-g001.jpg

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