在“健康老龄化运动研究”中，HIV感染者的变时性功能不全通过运动训练得到改善。
Chronotropic Incompetence among People with HIV Improves with Exercise Training in the Exercise for Healthy Aging Study.
作者信息
Durstenfeld Matthew S, Wilson Melissa P, Jankowski Catherine M, Ditzenberger Grace L, Longenecker Chris T, Erlandson Kristine M
机构信息
Division of Cardiology at ZSFG and Department of Medicine, University of California, San Francisco (UCSF), USA.
Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA.
出版信息
medRxiv. 2023 Nov 10:2023.11.10.23298367. doi: 10.1101/2023.11.10.23298367.
BACKGROUND
People with HIV (PWH) have lower exercise capacity compared to HIV-uninfected peers, which may be explained by chronotropic incompetence (CI), the inability to increase heart rate during exercise.
METHODS
The Exercise for Healthy Aging Study included adults ages 50-75 with and without HIV. Participants completed 12 weeks of moderate intensity exercise, before randomization to moderate or high intensity for 12 additional weeks. We compared adjusted heart rate reserve (AHRR; CI <80%) on cardiopulmonary exercise testing by HIV serostatus, and change from baseline to 12 and 24 weeks using mixed effects models.
RESULTS
Among 32 PWH and 37 controls (median age 56, 7% female, mean BMI 28 kg/m), 28% of PWH compared to 11% of controls had CI at baseline (p=0.067). AHRR was lower among PWH (91 vs 102%; difference 11%, 95% CI 2.5-19.7; p=0.01). At week 12, AHRR normalized among PWH (+8%, 95% CI 4-11; p<0.001) and was sustained at week 24 (+5, 95%CI 1-9; p=0.008) compared to no change among controls (95%CI -4 to 4; p=0.95; p=0.004). After 24 weeks of exercise, only 15% PWH and 10% of controls had CI (p=0.70).
CONCLUSIONS
Chronotropic incompetence contributes to reduced exercise capacity among PWH and improves with exercise training.
背景
与未感染艾滋病毒的同龄人相比，艾滋病毒感染者（PWH）的运动能力较低，这可能是由于变时性功能不全（CI），即运动时无法增加心率所致。
方法
健康老龄化运动研究纳入了年龄在50 - 75岁的有或无艾滋病毒的成年人。参与者先完成12周的中等强度运动，然后随机分为中等强度或高强度运动组，再进行12周运动。我们通过艾滋病毒血清学状态比较了心肺运动测试中调整后的心率储备（AHRR；CI <80%），并使用混合效应模型比较了从基线到12周和24周的变化。
结果
在32名艾滋病毒感染者和37名对照组（中位年龄56岁，7%为女性，平均BMI 28 kg/m）中，28%的艾滋病毒感染者在基线时有CI，而对照组为11%（p = 0.067）。艾滋病毒感染者的AHRR较低（91%对102%；差异11%，95%CI 2.5 - 19.7；p = 0.01）。在第12周时，艾滋病毒感染者的AHRR恢复正常（增加8%，95%CI 4 - 11；p <0.001），并在第24周时保持（增加5%，95%CI 1 - 9；p = 0.008），而对照组无变化（95%CI -4至4；p = 0.95；p = 0.004）。运动24周后，只有15%的艾滋病毒感染者和10%的对照组有CI（p = 0.70）。
结论
变时性功能不全导致艾滋病毒感染者运动能力下降，而运动训练可改善这一情况。
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