不同训练模式对射血分数保留心力衰竭患者骨骼肌分子改变的影响：OptimEx 试验的一个子研究。
Impact of Different Training Modalities on Molecular Alterations in Skeletal Muscle of Patients With Heart Failure With Preserved Ejection Fraction: A Substudy of the OptimEx Trial.
机构信息
Laboratory of Molecular and Experimental Cardiology, Technische Universität Dresden, Heart Center Dresden, Germany (E.B.W., A.A., A.S., K.G., J.H., A.L., V.A.).
Department of Prevention and Sports Medicine, University Hospital Klinikum rechts der Isar, Technical University of Munich, Germany (S.M., M.H.).
出版信息
Circ Heart Fail. 2022 Oct;15(10):e009124. doi: 10.1161/CIRCHEARTFAILURE.121.009124. Epub 2022 Oct 6.
BACKGROUND
Exercise intolerance is a cardinal feature of heart failure with preserved ejection fraction and so far exercise training (ET) is the most effective treatment. Since the improvement in exercise capacity is only weakly associated with changes in diastolic function other mechanisms, like changes in the skeletal muscle, contribute to improvement in peak oxygen consumption. The aim of the present study was to analyze molecular changes in skeletal muscle of patients with heart failure with preserved ejection fraction performing different ET modalities.
METHODS
Skeletal muscle biopsies were taken at study begin and after 3 and 12 months from patients with heart failure with preserved ejection fraction randomized either into a control group (guideline based advice for ET), a high-intensity interval training group (HIIT) or a moderate continuous training group. The first 3 months of ET were supervised in-hospital followed by 9 months home-based ET. Protein and mRNA expression of atrophy-related proteins, enzyme activities of enzymes linked to energy metabolism and satellite cells (SCs) were quantified.
RESULTS
Exercise capacity improved 3 months after moderate continuous exercise training and HIIT. This beneficial effect was lost after 12 months. HIIT mainly improved markers of energy metabolism and the amount and function of SC, with minor changes in markers for muscle atrophy. Only slight changes were observed after moderate continuous exercise training. The molecular changes were no longer detectable after 12 months.
CONCLUSIONS
Despite similar improvements in exercise capacity by HIIT and moderate continuous exercise training after 3 months, only HIIT altered proteins related to energy metabolism and amount/function of SC. These effects were lost after switching from in-hospital to at-home-based ET.
REGISTRATION
URL: https://www.
CLINICALTRIALS
gov; Unique identifier: NCT02078947.
背景
运动不耐受是射血分数保留型心力衰竭的主要特征，迄今为止，运动训练（ET）是最有效的治疗方法。由于运动能力的改善与舒张功能的变化仅弱相关，因此其他机制，如骨骼肌的变化，有助于改善峰值耗氧量。本研究的目的是分析射血分数保留型心力衰竭患者在进行不同 ET 方式时骨骼肌的分子变化。
方法
从射血分数保留型心力衰竭患者中随机抽取骨骼肌活检，分别进入对照组（基于指南的 ET 建议）、高强度间歇训练组（HIIT）或中等持续训练组。前 3 个月的 ET 在医院进行监督，然后进行 9 个月的家庭 ET。定量测定萎缩相关蛋白的蛋白质和 mRNA 表达、与能量代谢相关的酶的酶活性以及卫星细胞（SCs）。
结果
中等持续运动训练和 HIIT 后 3 个月运动能力提高。这种有益的效果在 12 个月后消失。HIIT 主要改善能量代谢标志物和 SC 的数量和功能，而肌肉萎缩标志物变化较小。中等持续运动训练后仅观察到轻微变化。12 个月后，分子变化不再可检测到。
结论
尽管 HIIT 和中等持续运动训练在 3 个月后均可使运动能力得到相似的改善，但只有 HIIT 改变了与能量代谢和 SC 数量/功能相关的蛋白质。从医院转为家庭 ET 后，这些影响消失了。
登记
网址：https://www.。
临床试验
clinicaltrials.gov；独特标识符：NCT02078947。
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