高强度间歇训练对初发心脏移植患者心脏重塑、功能及冠状动脉微循环的影响：HITTS随机对照试验的一项子研究
Effects of high-intensity interval training on cardiac remodelling, function and coronary microcirculation in de novo heart transplant patients: a substudy of the HITTS randomised controlled trial.
作者信息
Rafique Muzammil, Solberg Ole Geir, Gullestad Lars, Bendz Bjørn, Murbræch Klaus, Nytrøen Kari, Rolid Katrine, Lunde Ketil
机构信息
Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
出版信息
BMJ Open Sport Exerc Med. 2023 Jul 9;9(3):e001331. doi: 10.1136/bmjsem-2022-001331. eCollection 2023.
OBJECTIVES
High-intensity interval training (HIT) improves peak oxygen consumption (VO2peak) in de novo heart transplant (HTx) recipients. It remains unclear whether this improvement early after HTx is solely dependent on peripheral adaptations, or due to a linked chain of central and peripheral adaptations. The objective of this study was to determine whether HIT results in structural and functional adaptations in the cardiovascular system.
METHODS
Eighty-one de novo HTx recipients were randomly assigned to participate in either 9 months of supervised HIT or standard care exercise-based rehabilitation. Cardiac function was assessed by echocardiogram and the coronary microcirculation with the index of microcirculatory resistance (IMR) at baseline and 12 months after HTx.
RESULTS
Cardiac function as assessed by global longitudinal strain was significantly better in the HIT group than in the standard care group (16.3±1.2% vs 15.6±2.2%, respectively, treatment effect = -1.1% (95% CI -2.0% to -0.2%), p=0.02), as was the end-diastolic volume (128.5±20.8 mL vs 123.4±15.5 mL, respectively, treatment effect=4.9 mL (95% CI 0.5 to 9.2 mL), p=0.03). There was a non-significant tendency for IMR to indicate improved microcirculatory function (13.8±8.0 vs 16.8±12.0, respectively, treatment effect = -4.3 (95% CI -9.1 to 0.6), p=0.08).
CONCLUSION
When initiated early after HTx, HIT leads to both structural and functional cardiovascular adaptations.
TRIAL REGISTRATION NUMBER
NCT01796379.
目的
高强度间歇训练（HIT）可改善初次心脏移植（HTx）受者的峰值耗氧量（VO2peak）。目前尚不清楚HTx术后早期这种改善是否仅依赖于外周适应性变化，还是由于中枢和外周适应性变化的连锁反应。本研究的目的是确定HIT是否会导致心血管系统的结构和功能适应性变化。
方法
81例初次HTx受者被随机分配参加为期9个月的有监督的HIT或基于标准护理的运动康复训练。在基线时和HTx术后12个月，通过超声心动图评估心脏功能，并使用微循环阻力指数（IMR）评估冠状动脉微循环。
结果
通过整体纵向应变评估的心脏功能，HIT组显著优于标准护理组（分别为16.3±1.2%和15.6±2.2%，治疗效果=-1.1%（95%CI -2.0%至-0.2%），p=0.02），舒张末期容积也是如此（分别为128.5±20.8mL和123.4±15.5mL，治疗效果=4.9mL（95%CI 0.5至9.2mL），p=0.03）。IMR显示微循环功能改善的趋势不显著（分别为13.8±8.0和16.8±12.0，治疗效果=-4.3（95%CI -9.1至0.6），p=0.08）。
结论
在HTx术后早期开始进行HIT，可导致心血管系统的结构和功能适应性变化。
试验注册号
NCT01796379。
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