IRCCS SDN Nuclear and Diagnostic Research Institute, Naples, Italy.
Department of Translational Medical Sciences, Federico II University, Naples, Italy.
Heart Fail Clin. 2021 Jul;17(3):397-413. doi: 10.1016/j.hfc.2021.03.004.
Exercise intolerance represents a typical feature of heart failure with preserved ejection fraction (HFpEF), and is associated with a poor quality of life, frequent hospitalizations, and increased all-cause mortality. The cardiopulmonary exercise test is the best method to quantify exercise intolerance, and allows detection of the main mechanism responsible for the exercise limitation, influencing treatment and prognosis. Exercise training programs improve exercise tolerance in HFpEF. However, studies are needed to identify appropriate type and duration. This article discusses the pathophysiology of exercise limitation in HFpEF, describes methods of determining exercise tolerance class, and evaluates prognostic implications and potential therapeutic strategies.
运动耐量受损是射血分数保留的心力衰竭（HFpEF）的典型特征，与生活质量差、频繁住院和全因死亡率增加有关。心肺运动试验是量化运动耐量受损的最佳方法，可检测导致运动受限的主要机制，从而影响治疗和预后。运动训练方案可改善 HFpEF 患者的运动耐量。但是，需要进一步研究来确定合适的运动类型和运动时间。本文讨论了 HFpEF 患者运动受限的病理生理学，描述了确定运动耐量分级的方法，并评估了预后意义和潜在的治疗策略。
