Kourek Christos, Alshamari Manal, Mitsiou Georgios, Psarra Katherina, Delis Dimitrios, Linardatou Vasiliki, Pittaras Theodoros, Ntalianis Argyrios, Papadopoulos Costas, Panagopoulou Niki, Vasileiadis Ioannis, Nanas Serafim, Karatzanos Eleftherios
Clinical Ergospirometry, Exercise & Rehabilitation Laboratory, Evaggelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Immunology and Histocompatibility Department, Evaggelismos General Hospital, Athens, Greece.
Int J Cardiol Heart Vasc. 2020 Dec 24;32:100702. doi: 10.1016/j.ijcha.2020.100702. eCollection 2021 Feb.
Vascular endothelial dysfunction is an underlying pathophysiological feature of chronic heart failure (CHF). Endothelial progenitor cells (EPCs) are also impaired. The purpose of the study was to assess the effect of a cardiac rehabilitation (CR) program on the increase of EPCs at rest and on the acute response after maximal exercise in patients with CHF and investigate whether there were differences between two exercise training protocols and patients of NYHA II and III classes.
Forty-four patients with stable CHF enrolled in a 36-session CR program and were randomized in one training protocol; either high-intensity interval training (HIIT) or HIIT combined with muscle strength (COM). All patients underwent maximum cardiopulmonary exercise testing (CPET) before and after the CR program and venous blood was drawn before and after each CPET. Five endothelial cellular populations, expressed as cells/10 enucleated cells, were quantified by flow cytometry.
An increase in all endothelial cellular populations at rest was observed after the CR program (p < 0.01). The acute response after maximum exercise increased in 4 out of 5 endothelial cellular populations after rehabilitation. Although there was increase in EPCs at rest and the acute response after rehabilitation in each exercise training group and each NYHA class, there were no differences between HIIT and COM groups or NYHA II and NYHA III classes (p > 0.05).
A 36-session CR program increases the acute response after maximum CPET and stimulates the long-term mobilization of EPCs at rest in patients with CHF. These benefits seem to be similar between HIIT and COM exercise training protocols and between patients of different functional classes.
血管内皮功能障碍是慢性心力衰竭（CHF）潜在的病理生理特征。内皮祖细胞（EPCs）也受到损害。本研究的目的是评估心脏康复（CR）计划对CHF患者静息状态下EPCs增加以及最大运动后急性反应的影响，并调查两种运动训练方案以及纽约心脏协会（NYHA）II级和III级患者之间是否存在差异。
44例稳定型CHF患者参加了为期36节的CR计划，并随机分为一种训练方案；即高强度间歇训练（HIIT）或HIIT联合肌肉力量训练（COM）。所有患者在CR计划前后均接受了最大心肺运动测试（CPET），并在每次CPET前后采集静脉血。通过流式细胞术对五个内皮细胞群体进行定量，以每10个去核细胞中的细胞数表示。
CR计划后观察到静息状态下所有内皮细胞群体均增加（p < 0.01）。康复后，5个内皮细胞群体中有4个在最大运动后的急性反应增加。尽管每个运动训练组和每个NYHA级别在康复后静息状态下EPCs增加且急性反应增强，但HIIT组和COM组之间或NYHA II级和NYHA III级之间没有差异（p > 0.05）。
为期36节的CR计划可增加最大CPET后的急性反应，并刺激CHF患者静息状态下EPCs的长期动员。这些益处似乎在HIIT和COM运动训练方案之间以及不同功能级别的患者之间相似。
