Exercise training is a major, and the most important, component of cardiac rehabilitation. Besides providing psychological benefits and promoting a "sense of well being," it elicits a number of adaptations in patients with ischemic heart disease. Among the clinically important adaptations are changes in the trained skeletal muscles and autonomic nervous system, resulting not only in increased maximum exercise capacity but also a slower heart rate and, at times, a lower systolic blood pressure during submaximal exercise. The reduction in the rate pressure product decreases myocardial O2 demand at any given submaximal exercise intensity and may thus alleviate myocardial ischemia and angina in patients with coronary artery disease. These adaptive responses occur even with a relatively modest exercise intensity. Although short-term exercise training of moderate intensity has not been reported to result in improvement in left ventricular performance, recent data suggest that exercise training of higher intensity and longer duration (12 months or longer) than has conventionally been used in cardiac rehabilitation programs may favorably affect the heart. This is characterized by improvements in left ventricular function, diminished electrocardiographic criteria of myocardial ischemia and increased stroke volume during exercise. Modest weight reduction accompanies regularly performed prolonged exercise training. It is important, however, to recognize that high-intensity exercise programs are suitable for only some patients with coronary artery disease who are stable and should be used only under strict medical supervision.
运动训练是心脏康复的主要且最重要的组成部分。除了带来心理益处和提升“幸福感”外，它还能使缺血性心脏病患者产生一系列适应性变化。临床上重要的适应性变化包括训练后的骨骼肌和自主神经系统的改变，这不仅能提高最大运动能力，还能使心率减慢，有时在次最大运动时收缩压降低。心率血压乘积的降低可在任何给定的次最大运动强度下降低心肌氧需求，从而缓解冠心病患者的心肌缺血和心绞痛。即使运动强度相对适中，这些适应性反应也会出现。虽然尚未有报道称中等强度的短期运动训练能改善左心室功能，但最近的数据表明，比心脏康复项目中传统使用的强度更高、持续时间更长（12个月或更长时间）的运动训练可能会对心脏产生有益影响。这表现为左心室功能改善、心肌缺血的心电图标准降低以及运动期间每搏输出量增加。定期进行长时间运动训练会伴随适度的体重减轻。然而，必须认识到高强度运动项目仅适用于一些病情稳定的冠心病患者，且只能在严格的医疗监督下使用。
