Perrone Marco Alfonso, Iellamo Ferdinando, D'Antoni Valentino, Gismondi Alessandro, Di Biasio Deborah, Vadalà Sara, Marazzi Giuseppe, Morsella Valentina, Volterrani Maurizio, Caminiti Giuseppe
Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy.
Cardiology Rehabilitation Unit, IRCCS San Raffaele, 00163 Rome, Italy.
J Pers Med. 2023 Aug 18;13(8):1272. doi: 10.3390/jpm13081272.
the aim of this study was to assess acute changes in left atrial (LA) function during incremental aerobic exercise in patients with heart failure with mildly reduced ejection fraction (HFmrEF) in comparison to healthy subjects (HS).
twenty patients with established HFmrEF were compared with 10 HS, age-matched controls. All subjects performed a stepwise exercise test on a cycle ergometer. Echocardiography was performed at baseline, during submaximal effort, at peak of exercise, and after 5 min of recovery.
HS obtained a higher value of METs at peak exercise than HFmrEF (7.4 vs. 5.6; between group = 0.002). Heart rate and systolic blood pressure presented a greater increase in the HS group than in HFmrEF (between groups = 0.006 and 0.003, respectively). In the HFmrEF group, peak atrial longitudinal strain (PALS) and conduit strain were both increased at submaximal exercise ( < 0.05 for both versus baseline) and remained constant at peak exercise. Peak atrial contraction strain (PACS) did not show significant changes during the exercise. In the HS group, PALS and PACS increased significantly at submaximal level ( < 0.05 for both versus baseline), but PALS returned near baseline values at peak exercise; conduit strain decreased progressively during the exercise in HS. Stroke volume (SV) increased in both groups at submaximal exercise; at peak exercise, SV remained constant in the HFmrEF, while it decreased in controls (between groups = 0.002).
patients with HFmrEF show a proper increase in LA reservoir function during incremental aerobic exercise that contributes to maintain SV throughout the physical effort.
本研究旨在评估射血分数轻度降低的心力衰竭（HFmrEF）患者与健康受试者（HS）相比，在递增有氧运动期间左心房（LA）功能的急性变化。
将20例确诊为HFmrEF的患者与10例年龄匹配的HS对照进行比较。所有受试者在自行车测力计上进行逐步运动试验。在基线、次最大努力时、运动峰值时和恢复5分钟后进行超声心动图检查。
HS在运动峰值时的代谢当量值高于HFmrEF（7.4对5.6；组间差异 = 0.002）。心率和收缩压在HS组中的升高幅度大于HFmrEF组（组间差异分别为0.006和0.003）。在HFmrEF组中，次最大运动时峰值心房纵向应变（PALS）和管道应变均增加（两者与基线相比均P < 0.05），并在运动峰值时保持不变。运动期间峰值心房收缩应变（PACS）未显示出显著变化。在HS组中，次最大运动水平时PALS和PACS均显著增加（两者与基线相比均P < 0.05），但运动峰值时PALS恢复到接近基线值；HS组中管道应变在运动过程中逐渐降低。两组在次最大运动时每搏输出量（SV）均增加；运动峰值时，HFmrEF组的SV保持不变，而对照组的SV降低（组间差异 = 0.002）。
HFmrEF患者在递增有氧运动期间左心房储备功能有适当增加，这有助于在体力活动期间维持SV。
