老年慢性心力衰竭患者心脏康复运动对血管内皮功能的影响。
The impact of cardiomotor rehabilitation on endothelial function in elderly patients with chronic heart failure.
机构信息
Department of General Practice, The First Affiliated Hospital of Hainan Medical University, Haikou City, 570102, Hainan Province, China.
Graduate School, Hainan Medical University, China Medical University, Haikou City, 571199, Hainan Province, China.
出版信息
BMC Cardiovasc Disord. 2021 Nov 1;21(1):524. doi: 10.1186/s12872-021-02327-5.
BACKGROUND
To explore the effects of cardiac exercise rehabilitation on peripheral blood endothelial progenitor cells (EPC) in elderly patients with chronic heart failure.
METHODS
80 elderly patients with chronic heart failure were selected from March 2017 to March 2019 and randomly divided into two groups (N = 40). The control group was treated routinely and walked freely for 30-60 min every day. The patients in the exercise rehabilitation group developed a cardiac exercise rehabilitation plan. Then, cardiac function and peripheral blood B-natriuretic peptide (BNP) levels in the two groups were compared. The cell viability, proliferation, apoptosis, and invasion ability of EPCs were detected. The levels of the PI3K/AKT pathway and eNOS and VEGF were compared.
RESULTS
There were no significant differences in all indexes between the two groups before treatment (P > 0.05), and both improved significantly after treatment (P < 0.05). After treatment, LVEF and LVFS in the exercise rehabilitation group were significantly higher than those in the control group (P < 0.05), and LVEDD and LVESD were significantly lower than those in the control group (P < 0.05). The BNP level in the exercise rehabilitation group was significantly lower than that in the control group (P < 0.05). The cell viability, proliferation, invasion ability of EPC, and the levels of PI3K, AKT, eNOS, and VEGF mRNA and protein in the exercise rehabilitation group were significantly higher than those in the control group. Apoptosis rate was significantly lower than those in the control group (P < 0.05).
CONCLUSIONS
Visceral exercise rehabilitation can improve cardiac ejection and myocardial function in elderly patients with chronic heart failure, and can promote the vitality, proliferation, and invasion of peripheral blood EPC, and promote the expression of eNOS and VEGF by upregulating the PI3K/AKT pathway to promote angiogenesis and endothelial function.
背景
探讨心脏运动康复对老年慢性心力衰竭患者外周血内皮祖细胞（EPC）的影响。
方法
选择 2017 年 3 月至 2019 年 3 月收治的 80 例老年慢性心力衰竭患者，随机分为两组（n=40）。对照组常规治疗，每天自由行走 30-60min。运动康复组制定心脏运动康复计划。比较两组患者心功能和外周血 B 型利钠肽（BNP）水平，检测 EPC 细胞活力、增殖、凋亡和侵袭能力，比较 PI3K/AKT 通路和 eNOS、VEGF 水平。
结果
两组治疗前各项指标差异均无统计学意义（P>0.05），治疗后均明显改善（P<0.05）。治疗后，运动康复组 LVEF 和 LVFS 明显高于对照组（P<0.05），LVEDD 和 LVESD 明显低于对照组（P<0.05）。运动康复组 BNP 水平明显低于对照组（P<0.05）。EPC 细胞活力、增殖、侵袭能力以及 PI3K、AKT、eNOS、VEGF mRNA 和蛋白水平均明显高于对照组，凋亡率明显低于对照组（P<0.05）。
结论
内脏运动康复可改善老年慢性心力衰竭患者的心排血量和心肌功能，促进外周血 EPC 的活力、增殖和侵袭，通过上调 PI3K/AKT 通路促进 eNOS 和 VEGF 的表达，促进血管生成和内皮功能。
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