腿部为主的高负重抗阻训练可改善 Fontan 循环的年轻患者的心室每搏量、运动能力和力量。
Leg-focused high-weight resistance training improves ventricular stroke volume, exercise capacity and strength in young patients with a Fontan circulation.
机构信息
Department of Pediatrics, Division of Pediatric Cardiology, Erasmus MC-Sophia Children's Hospital, Doctor Molewaterplein 40, 3015 GD, Rotterdam, Netherlands.
Department of Pediatric Gastroenterology, Division of Pediatric Cardiology, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands.
出版信息
Eur J Prev Cardiol. 2024 Mar 4;31(4):389-399. doi: 10.1093/eurjpc/zwad286.
AIMS
Effective therapy to improve exercise capacity in Fontan patients is lacking. Leg-focused high-weight resistance training might augment the peripheral muscle pump and thereby improve exercise capacity.
METHODS AND RESULTS
This randomized semi-cross-over controlled trial investigated the effects of a 12-week leg-focused high-weight resistance training plus high-protein diet, on (sub)maximal exercise capacity, cardiac function (assessed with cardiovascular magnetic resonance), muscle strength, and quality of life in paediatric Fontan patients. Twenty-eight paediatric Fontan patients were included, 27 patients, (median age 12.9 [10.5-15.7]), and successfully completed the programme. Peak oxygen uptake (PeakVO2) at baseline was reduced [33.3 mL/kg/min (27.1-37.4), 73% (62-79) of predicted]. After training PeakVO2/kg and Peak workload improved significantly with +6.2 mL/kg/min (95%CI: 3.4-9.0) (+18%) P < 0.001 and +22 Watts (95%CI: 12-32) (+18%) P < 0.001, respectively, compared to the control period. Indexed single ventricle stroke volume increased significantly [43 mL/beat/m2 (40-49) vs. 46 (41-53), P = 0.014], as did inferior vena cava flow [21 mL/beat/m2 (18-24) vs. 23 (20-28), P = 0.015], while superior vena cava flow remained unchanged. The strength of all measured leg-muscles increased significantly compared to the control period. Self-reported quality of life improved on the physical functioning and change in health domains of the child health questionnaire, parent-reported quality of life improved the bodily pain, general health perception, and change in health domains compared to the control period.
CONCLUSION
In a relatively large group of 27 older Fontan children, 12-weeks of leg-focused high-weight resistance training improved exercise capacity, stroke volume, (sub)maximal exercise capacity, muscle strength, and domains of quality of life.
REGISTRATION
International Clinical Trials: Trial NL8181.
目的
改善 Fontan 患者运动能力的有效治疗方法仍有待探索。以腿部为重点的高强度抗阻训练可能会增强外周肌肉泵的功能，从而提高运动能力。
方法和结果
本项随机半交叉对照试验研究了为期 12 周的腿部高强度抗阻训练加高蛋白饮食对儿科 Fontan 患者（亚）最大运动能力、心功能（心血管磁共振评估）、肌肉力量和生活质量的影响。共纳入 28 名儿科 Fontan 患者，其中 27 名患者（中位年龄 12.9 [10.5-15.7] 岁）成功完成了该方案。基线时峰值摄氧量（PeakVO2）降低[33.3 毫升/公斤/分钟（27.1-37.4），73%（62-79）预测值]。训练后，与对照组相比，PeakVO2/kg 和 Peak 工作负荷分别显著增加了+6.2 毫升/公斤/分钟（95%CI：3.4-9.0；+18%），P < 0.001和+22 瓦特（95%CI：12-32；+18%），P < 0.001。单心室指数射血量显著增加[43 毫升/搏/平方米（40-49）比 46（41-53），P = 0.014]，下腔静脉血流量也显著增加[21 毫升/搏/平方米（18-24）比 23（20-28），P = 0.015]，而上腔静脉血流量无变化。与对照组相比，所有测量的腿部肌肉力量均显著增加。与对照组相比，儿童健康问卷的身体功能和健康变化领域自我报告的生活质量改善，父母报告的生活质量在身体疼痛、一般健康感知和健康变化领域改善。
结论
在 27 名年龄较大的 Fontan 儿童中，12 周腿部高强度抗阻训练可提高运动能力、射血量、（亚）最大运动能力、肌肉力量和生活质量。
注册
国际临床试验：NL8181 试验。
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