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患有冠心病的女性和男性对不同的有氧运动训练方式的反应相似:前瞻性随机试验的汇总分析。

Women and men with coronary heart disease respond similarly to different aerobic exercise training modalities: a pooled analysis of prospective randomized trials.

机构信息

Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, QC H1T 1N6, Canada.

Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada.

出版信息

Appl Physiol Nutr Metab. 2021 May;46(5):417-425. doi: 10.1139/apnm-2020-0650. Epub 2020 Oct 23.

Abstract

We aimed to compare cardiopulmonary exercise test (CPET) parameters, cardiac adaptations, and proportion of responders after different aerobic training programs amongst women and men with coronary heart disease (CHD). Patients with CHD were evaluated with a CPET and echocardiography before and after 3 months of aerobic exercise training. Peak oxygen uptake exercise training response was assessed according to the median peak oxygen uptake change for post- versus pretraining in the whole cohort (stratification non/low responders (NLR) vs. high-responders) and normalized for lean body mass (LBM). Eighty-three CHD patients were included (19 women, 64 men; 27 patients with interval, 19 with continuous, and 37 with combination exercises). Peak oxygen uptake, peak workload normalized for LBM, pulmonary variables (i.e., ventilation and oxygen uptake efficiency slope), and O pulse were significantly lower in women versus men. These parameters improved similarly with training in both sexes ( < 0.05). There were no differences in the proportion of NLR among women and men with CHD (7/19 (37%) vs. 35/64 (55%), = 0.1719). Left ventricular ejection fraction and mean peak early diastolic mitral annulus velocity improved similarly with training in both sexes ( < 0.05). Women and men with CHD have a similar exercise training response regarding key CPET and echocardiographic parameters. The proportion of responders is similar. ClinicalTrials.gov: NCT03414996, NCT02048696, NCT03443193. Cardiopulmonary adaptations to exercise training are similar among CHD men and women. Proportion of peak oxygen uptake for non/low/high responders is similar in CHD men and women. Left ventricular systolic and diastolic function improved similarly after exercise training in CHD men and women.

摘要

我们旨在比较女性和男性冠心病患者在不同有氧运动训练方案后的心肺运动试验(CPET)参数、心脏适应性和反应者比例。所有患者在进行 3 个月有氧运动训练前后均接受 CPET 和超声心动图检查。根据整个队列的训练后和训练前峰值摄氧量变化中位数评估峰值摄氧量运动训练反应(分层无/低反应者(NLR)与高反应者),并按瘦体重(LBM)进行归一化。共有 83 例 CHD 患者入选(19 例女性,64 例男性;27 例患者采用间隔式、19 例采用连续式、37 例采用组合式运动)。女性的峰值摄氧量、按 LBM 归一化的峰值工作量、肺功能参数(即通气和摄氧效率斜率)和 O 脉冲均明显低于男性。这些参数在两性中均随着训练而得到相似的改善(<0.05)。冠心病女性和男性中 NLR 的比例无差异(7/19(37%)与 35/64(55%),=0.1719)。左心室射血分数和平均早期舒张二尖瓣环速度在两性中随着训练而得到相似的改善(<0.05)。冠心病女性和男性在关键 CPET 和超声心动图参数方面具有相似的运动训练反应。反应者的比例相似。ClinicalTrials.gov:NCT03414996、NCT02048696、NCT03443193。冠心病男女患者的运动心肺适应性相似。冠心病男女患者的最大摄氧量非/低/高反应者比例相似。冠心病男女患者在运动训练后左心室收缩和舒张功能均得到相似的改善。

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