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慢性心力衰竭康复:膈肌训练需要更多关注。

Chronic Heart Failure Rehabilitation: Diaphragm Training Needs More Attention.

作者信息

Bordoni Bruno, Morabito Bruno, Myftari Vincenzo, D'Amato Andrea, Severino Paolo

机构信息

Department of Cardiopneumology, Fondazione Don Carlo Gnocchi Onlus IRCCS, 20121 Milano, Italy.

Fondazione Policlinico Universitario Agostino Gemelli, Università Cattolica Del Sacro Cuore, 00168 Roma, Italy.

出版信息

J Clin Med. 2025 Aug 8;14(16):5624. doi: 10.3390/jcm14165624.

Abstract

BACKGROUND

Chronic heart failure (HF) is a systemic condition in which the heart is unable to meet the body's peripheral demands, leading to both acute and chronic functional decline, accompanied by high morbidity and mortality rates. A non-pharmacological, non-surgical standard approach to managing HF is cardiovascular rehabilitation, which is widely endorsed by international cardiology societies. This typically includes aerobic and anaerobic physical activity involving the peripheral skeletal muscles. However, international guidelines often overlook the clinical significance of the diaphragm and the role of inspiratory muscle training (IMT) in rehabilitation. The diaphragm plays a critical role not only in respiratory and cardiac function but also in supporting limb movements and overall physical performance. In patients with HF, diaphragmatic dysfunction contributes significantly to the symptoms they experience.

CONCLUSIONS

This review highlights the need for a greater emphasis on incorporating IMT into the standard rehabilitation protocols for patients with HF, given its potential to improve both respiratory function and overall physical capacity.

摘要

背景

慢性心力衰竭(HF)是一种全身性疾病,心脏无法满足身体的外周需求,导致急性和慢性功能衰退,伴有高发病率和死亡率。管理心力衰竭的一种非药物、非手术标准方法是心脏康复,这得到了国际心脏病学会的广泛认可。这通常包括涉及外周骨骼肌的有氧和无氧体育活动。然而,国际指南往往忽视了膈肌的临床意义以及吸气肌训练(IMT)在康复中的作用。膈肌不仅在呼吸和心脏功能中起关键作用,而且在支持肢体运动和整体身体表现方面也起着关键作用。在心力衰竭患者中,膈肌功能障碍是导致他们所经历症状的重要因素。

结论

本综述强调,鉴于吸气肌训练有可能改善呼吸功能和整体身体能力,需要更加重视将其纳入心力衰竭患者的标准康复方案中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4972/12386739/3c963c289b3f/jcm-14-05624-g001.jpg

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