Cahalin Lawrence P, Formiga Magno F, Owens Johnny, Anderson Brady, Hughes Luke
Department of Physical Therapy, Miller School of Medicine, University of Miami, Miami, FL, United States.
Departamento de Fisioterapia, Faculdade de Medicina, Universidade Federal Do Ceará, Fortaleza, Brazil.
Front Physiol. 2022 Jul 6;13:924557. doi: 10.3389/fphys.2022.924557. eCollection 2022.
Blood flow restriction exercise (BFRE) has become a common method to increase skeletal muscle strength and hypertrophy for individuals with a variety of conditions. A substantial literature of BFRE in older adults exists in which significant gains in strength and functional performance have been observed without report of adverse events. Research examining the effects of BFRE in heart disease (HD) and heart failure (HF) appears to be increasing for which reason the Muscle Hypothesis of Chronic Heart Failure (MHCHF) will be used to fully elucidate the effects BFRE may have in patients with HD and HF highlighted in the MHCHF. A comprehensive literature review was performed in PubMed and the Cochrane library through February 2022. Inclusion criteria were: 1) the study was original research conducted in human subjects older than 18 years of age and diagnosed with either HD or HF, 2) study participants performed BFRE, and 3) post-intervention outcome measures of cardiovascular function, physical performance, skeletal muscle function and structure, and/or systemic biomarkers were provided. Exclusion criteria included review articles and articles on viewpoints and opinions of BFRE, book chapters, theses, dissertations, and case study articles. Seven BFRE studies in HD and two BFRE studies in HF were found of which four of the HD and the two HF studies examined a variety of measures reflected within the MHCHF over a period of 8-24 weeks. No adverse events were reported in any of the studies and significant improvements in skeletal muscle strength, endurance, and work as well as cardiorespiratory performance, mitochondrial function, exercise tolerance, functional performance, immune humoral function, and possibly cardiac performance were observed in one or more of the reviewed studies. In view of the above systematic review, BFRE has been performed safely with no report of adverse event in patients with a variety of different types of HD and in patients with HF. The components of the MHCHF that can be potentially improved with BFRE include left ventricular dysfunction, inflammatory markers, inactivity, a catabolic state, skeletal and possibly respiratory muscle myopathy, dyspnea and fatigue, ANS activity, and peripheral blood flow. Furthermore, investigation of feasibility, acceptability, adherence, adverse effects, and symptoms during and after BFRE is needed since very few studies have examined these important issues comprehensively in patients with HD and HF.
血流限制训练（BFRE）已成为一种常见方法，用于增强患有各种疾病的个体的骨骼肌力量和促进肌肉肥大。关于老年人进行BFRE的文献丰富，其中观察到力量和功能表现有显著提升，且未报告不良事件。研究BFRE对心脏病（HD）和心力衰竭（HF）影响的研究似乎在增加，因此将使用慢性心力衰竭肌肉假说（MHCHF）来全面阐明BFRE对HD和HF患者可能产生的影响，这在MHCHF中有所强调。截至2022年2月，在PubMed和Cochrane图书馆进行了全面的文献综述。纳入标准为：1）该研究是针对年龄大于18岁且被诊断患有HD或HF的人类受试者开展的原创研究；2）研究参与者进行了BFRE；3）提供了干预后心血管功能、身体表现、骨骼肌功能和结构以及/或全身生物标志物的结果测量。排除标准包括综述文章以及关于BFRE的观点和意见的文章、书籍章节、论文、学位论文和案例研究文章。共找到7项关于HD的BFRE研究和2项关于HF的BFRE研究，其中4项HD研究和2项HF研究在8至24周的时间内对MHCHF中反映的各种指标进行了检测。所有研究均未报告不良事件，且在一项或多项综述研究中观察到骨骼肌力量、耐力和做功以及心肺功能、线粒体功能、运动耐量、功能表现、免疫体液功能，甚至可能还有心脏功能有显著改善。鉴于上述系统综述，BFRE在患有各种不同类型HD的患者和HF患者中均安全进行，且未报告不良事件。BFRE可能改善的MHCHF组成部分包括左心室功能障碍、炎症标志物、缺乏运动、分解代谢状态、骨骼肌以及可能的呼吸肌肌病、呼吸困难和疲劳、自主神经活动以及外周血流。此外，由于很少有研究在HD和HF患者中全面研究这些重要问题，因此需要对BFRE期间及之后的可行性、可接受性、依从性、不良反应和症状进行调查。
