Trachsel Lukas D, David Louis-Philippe, Gayda Mathieu, Boidin Maxime, Lalongé Julie, Juneau Martin, Nigam Anil, Henri Christine
Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada.
Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.
Appl Physiol Nutr Metab. 2021 Dec;46(12):1502-1509. doi: 10.1139/apnm-2021-0055. Epub 2021 Jul 26.
Linear aerobic training periodisation (LP) is recommended for patients with coronary heart disease (CHD). However, the effects of training periodisation on the right heart mechanics in patients with CHD have never been examined. This study aimed to explore the effects of LP and non-linear periodisation (NLP) on right heart mechanics. We prospectively randomised CHD patients to 12 weeks of aerobic training with LP or NLP. While there was a weekly increase in energy expenditure with LP, there was a steeper increase during the first 3 weeks, followed by a decrease in the fourth week with NLP. Echocardiography was performed at baseline and after the training period to assess the right ventricular free wall (RVFW) and right atrial strain. Thirty patients with CHD were included (NLP, = 16; LP, = 14). The traditional right and left heart parameters showed no significant time effects. There was a decrease of RVFW strain with time in both groups (+1.3 ± 0.9% with NLP, and +1.5 ± 0.8% with LP; = 0.033). Mid-ventricular RVFW strain changed significantly with time (+2.0 ± 1.3% with NLP, and from +2.3 ± 1.2% with LP; = 0.025). There was no time effect on the right atrial strain. In stable CHD patients, LP and NLP resulted in right ventricular strain decrements with a segment-specific pattern. This study was registered at ClinicalTrials.gov (identifier number: NCT03414996). In stable coronary heart disease patients, both linear and non-linear aerobic training periodisation programs result in right ventricular strain decrements with time, particularly in the mid-ventricular segment. Traditional right and left heart parameters and right atrial strain showed no significant time effect in both 12 weeks aerobic training periodisation programs.
对于冠心病（CHD）患者，推荐采用线性有氧训练周期安排（LP）。然而，训练周期安排对CHD患者右心力学的影响从未被研究过。本研究旨在探讨LP和非线性周期安排（NLP）对右心力学的影响。我们将CHD患者前瞻性随机分为接受LP或NLP的12周有氧训练组。虽然LP组的能量消耗每周都有增加，但NLP组在前3周增加更为陡峭，随后在第4周下降。在基线和训练期结束后进行超声心动图检查，以评估右心室游离壁（RVFW）和右心房应变。纳入了30例CHD患者（NLP组 = 16例；LP组 = 14例）。传统的左右心参数未显示出显著的时间效应。两组的RVFW应变均随时间下降（NLP组为 +1.3±0.9%，LP组为 +1.5±0.8%；P = 0.033）。心室中部RVFW应变随时间有显著变化（NLP组为 +2.0±1.3%，LP组从 +2.3±1.2%变化；P = 0.025）。右心房应变没有时间效应。在稳定的CHD患者中，LP和NLP导致右心室应变呈节段特异性模式下降。本研究已在ClinicalTrials.gov注册（标识符编号：NCT03414996）。在稳定的冠心病患者中，线性和非线性有氧训练周期安排方案均导致右心室应变随时间下降，尤其是在心室中部节段。在为期12周的有氧训练周期安排方案中，传统的左右心参数和右心房应变均未显示出显著的时间效应。
