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抗阻运动康复联合乳清蛋白补充治疗射血分数保留心力衰竭伴肌少症老年患者的随机对照研究方案

Impact of resistance exercise rehabilitation and whey protein supplementation in elderly patients with heart failure with preserved ejection fraction with sarcopenia: a study protocol for a randomised controlled trial.

机构信息

Department of Health Care, China-Japan Friendship Hospital, Beijing, Beijing, China.

China-Japan Friendship School of Clinical Medicine, Peking University, Beijing, Beijing, China.

出版信息

BMJ Open. 2022 Dec 6;12(12):e066331. doi: 10.1136/bmjopen-2022-066331.

Abstract

INTRODUCTION

Heart failure with preserved ejection fraction (HFpEF) affects more than half of the patients with heart failure. HFpEF and sarcopenia can interact with each other and contribute to reduced physiological function and increased mortality in elderly patients. Resistance training (RT) or resistance exercise rehabilitation (RER) may have benefits for elderly HFpEF patients with sarcopenia. Whey protein supplementation (WPS) may increase the effects of exercise on strength and muscle mass, in addition to promoting heart function and quality of life (QoL). However, studies are needed to evaluate effects of RER and WPS in patients with HFpEF with sarcopenia.

METHODS AND ANALYSIS

This is a prospective, randomised, controlled clinical trial in which patients with HFpEF with sarcopenia will be randomly allocated to three groups, control, RT and RT+WP. Participants in all groups will receive basic intervention including standard medicine treatment, home-based aerobic exercise and basic nutritional intervention. The RT group will undergo resistance exercise programmes, and the RT+WP group will receive daily WPS apart from resistance exercise. The study variables will be evaluated at baseline and 12 weeks. Primary outcome measure is the change of 6 min walking distance. Secondary outcomes include parameters of muscle status, cardiac function, nutritional status, QoL and major adverse cardiovascular events. The primary efficacy analysis will follow the intention-to-treat principle.

ETHICS AND DISSEMINATION

This study was approved by Ethics Committee of China-Japan Friendship Hospital for Clinical Research (No. 2022-KY-003). The results of this study will be disseminated via peer-reviewed publications and presentations at conferences.

TRIAL REGISTRATION NUMBER

ChiCTR2200061069.

摘要

简介

射血分数保留的心力衰竭(HFpEF)影响了一半以上的心力衰竭患者。HFpEF 和肌肉减少症可以相互作用,导致老年患者生理功能下降和死亡率增加。阻力训练(RT)或阻力运动康复(RER)可能对老年 HFpEF 合并肌肉减少症患者有益。乳清蛋白补充(WPS)除了能改善心脏功能和生活质量(QoL)外,还可能增强运动对力量和肌肉质量的影响。然而,仍需要研究来评估 RER 和 WPS 对 HFpEF 合并肌肉减少症患者的影响。

方法和分析

这是一项前瞻性、随机、对照的临床试验,HFpEF 合并肌肉减少症患者将被随机分为三组,对照组、RT 组和 RT+WP 组。所有组别的参与者都将接受包括标准药物治疗、家庭有氧运动和基本营养干预在内的基础干预。RT 组将进行阻力运动方案,而 RT+WP 组除了进行阻力运动外,还将每天接受 WPS。研究变量将在基线和 12 周时进行评估。主要观察指标是 6 分钟步行距离的变化。次要结局包括肌肉状态、心脏功能、营养状况、QoL 和主要不良心血管事件的参数。主要疗效分析将遵循意向治疗原则。

伦理和传播

本研究已获得中日友好医院临床研究伦理委员会的批准(No. 2022-KY-003)。本研究的结果将通过同行评议的出版物和会议报告进行传播。

试验注册号

ChiCTR2200061069。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bb1/9730387/1bd0d2c77a24/bmjopen-2022-066331f01.jpg

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