Caminiti Giuseppe, Perrone Marco Alfonso, D'Antoni Valentino, Marazzi Giuseppe, Gismondi Alessandro, Vadalà Sara, Di Biasio Deborah, Manzi Vincenzo, Iellamo Ferdinando, Volterrani Maurizio
Department of Human Science and Promotion of Quality of Life, San Raffaele Open University, 00163 Rome, Italy.
Cardiology Rehabilitation Unit, IRCCS San Raffaele, 00163 Rome, Italy.
J Cardiovasc Dev Dis. 2023 Jun 29;10(7):276. doi: 10.3390/jcdd10070276.
Left atrial dysfunction is associated with exercise intolerance and poor prognosis in heart failure (HF). The effects of exercise training on atrial function in patients with HF with mid-range ejection fraction (HFmrEF) are unknown. The purpose of the present study was to assess the effects of a supervised concurrent training (SCT) program, lasting 12 weeks, on left atrial function of patients with HFmrEF. The study included 70 stable patients, who were randomly assigned into two groups: SCT with (three sessions/week) or a control (CON) group directed to follow contemporary exercise preventive guidelines at home. Before starting the training program and at 12 weeks, all patients performed an ergometric test, a 6 min walk test, and echocardiography. Between-group comparisons were made by analysis of variance (ANOVA). At 12 weeks, the duration of the ergometric test and distance walked at 6 min walk test presented a significant greater increase in SCT compared to the control (between-group 0.0001 and 0.004 respectively). Peak atrial longitudinal strain and conduit strain presented an increase of 29% and 34%, respectively, in the SCT, and were unchanged in CON (between-group 0.008 and 0.001, respectively). Peak atrial contraction strain increased by 21% in SCT, with no changes in CON (between-group 0.002). Left ventricular global longitudinal strain increased significantly in SCT compared to control (between-groups 0.03). In conclusions, SCT improved left atrial and left ventricular function in HFmrEF. Further studies are needed in order to verify whether these favourable effects of SCT on LA function are sustained and whether they will translate into clinical benefits for patients with HFmrEF.
左心房功能障碍与心力衰竭（HF）患者的运动不耐受和不良预后相关。运动训练对射血分数中等范围的心力衰竭（HFmrEF）患者心房功能的影响尚不清楚。本研究的目的是评估一项为期12周的有监督的联合训练（SCT）计划对HFmrEF患者左心房功能的影响。该研究纳入了70例病情稳定的患者，他们被随机分为两组：SCT组（每周三次训练）和对照组（CON），对照组患者在家遵循当代运动预防指南。在开始训练计划前和12周时，所有患者均进行了运动耐力测试、6分钟步行测试和超声心动图检查。组间比较采用方差分析（ANOVA）。12周时，与对照组相比，SCT组的运动耐力测试持续时间和6分钟步行测试行走距离显著增加更多（组间比较分别为P<0.0001和P<0.004）。SCT组的心房纵向应变峰值和管道应变分别增加了29%和34%，而CON组无变化（组间比较分别为P<0.008和P<0.001）。SCT组的心房收缩应变峰值增加了21%，CON组无变化（组间比较P<0.002）。与对照组相比，SCT组的左心室整体纵向应变显著增加（组间比较P<0.03）。总之，SCT改善了HFmrEF患者的左心房和左心室功能。需要进一步研究以验证SCT对左心房功能的这些有利影响是否持续，以及它们是否会转化为HFmrEF患者的临床益处。
