Fukuta Hidekatsu
Core Laboratory, Nagoya City University Graduate School of Medical Sciences Nagoya, Japan.
Card Fail Rev. 2020 Oct 16;6:e27. doi: 10.15420/cfr.2020.17. eCollection 2020 Mar.
Nearly half of patients with heart failure in the community have heart failure with preserved ejection fraction (HFpEF). Patients with HFpEF are often elderly and their primary chronic symptom is severe exercise intolerance. Left ventricular diastolic dysfunction is associated with the pathophysiology of HFpEF and is an important contributor to exercise intolerance in HFpEF patients. The effects of exercise training on left ventricular diastolic function in HFpEF patients have been examined in several randomised clinical trials. Meta-analysis of the trials indicates that exercise training can provide clinically relevant improvements in exercise capacity without significant change in left ventricular structure or function in HFpEF patients. Further studies are necessary to elucidate the exact mechanisms of exercise intolerance in HFpEF patients and to develop recommendations regarding the most effective type, intensity, frequency, and duration of training in this group.
社区中近一半的心力衰竭患者为射血分数保留的心力衰竭（HFpEF）。HFpEF患者通常为老年人，其主要慢性症状是严重运动不耐受。左心室舒张功能障碍与HFpEF的病理生理学相关，是HFpEF患者运动不耐受的重要原因。几项随机临床试验研究了运动训练对HFpEF患者左心室舒张功能的影响。对这些试验的荟萃分析表明，运动训练可使HFpEF患者的运动能力在临床上得到相关改善，而左心室结构或功能无显著变化。有必要进一步研究以阐明HFpEF患者运动不耐受的确切机制，并就该组患者最有效的训练类型、强度、频率和持续时间制定建议。
