Keteyian S J, Levine A B, Brawner C A, Kataoka T, Rogers F J, Schairer J R, Stein P D, Levine T B, Goldstein S
Henry Ford Heart and Vascular Institute, Detroit, Michigan, USA.
Ann Intern Med. 1996 Jun 15;124(12):1051-7. doi: 10.7326/0003-4819-124-12-199606150-00004.
To assess the benefit of exercise training in patients with heart failure caused by left ventricular systolic dysfunction and to further describe the physiologic changes associated with exercise training in these patients.
Randomized, controlled trial.
Urban outpatient clinic.
40 men with compensated heart failure who were receiving standard medical therapy were randomly assigned to an exercise-training group or to a control group that did not exercise. Fifteen of the 21 patients assigned to exercise training and 14 of the 19 patients assigned to the control group completed the study.
Patients assigned to exercise training participated in a program of three exercise sessions per week for 24 weeks.
Symptom-limited exercise tests with gas exchange analysis done just before randomization, at week 12, and at week 24.
At week 24, the following changes (mean +/- SE) were seen in patients in the exercise group and patients in the control group, respectively; exercise duration, 2.8 +/- 0.6 minutes and 0.5 +/- 0.5 minutes; peak oxygen consumption (VO2), 231 +/- 54 L/min and 58 +/- 38 L/min; peak ventilation, 12 +/- 3 L/min and -4 +/- 3 L/min; peak heart rate, 10 +/- 4 beats/min and -2 +/- 4 beats/min; and peak power output, 20 +/- 6 W and 2 +/- 5 W. Differences between the increases occurring in the exercise group and the changes occurring in the control group were significant (P < 0.05). Among patients in the exercise group, 85% of the increase in peak VO2 occurred by week 12, and 46% of the increase in peak VO2 was caused by the increase in peak heart rate.
Exercise training does not appear to be contraindicated in patients with compensated heart failure. Exercise training improved exercise tolerance, as measured by increases in peak VO2, exercise duration, and power output. This improved exercise tolerance was caused in part by an increase in peak heart rate.
评估运动训练对左心室收缩功能障碍所致心力衰竭患者的益处，并进一步描述这些患者运动训练相关的生理变化。
随机对照试验。
城市门诊诊所。
40名接受标准药物治疗的代偿性心力衰竭男性患者，随机分为运动训练组或不运动的对照组。分配到运动训练组的21名患者中有15名，分配到对照组的19名患者中有14名完成了研究。
分配到运动训练组的患者参加每周三次运动课程，共24周的项目。
在随机分组前、第12周和第24周进行症状限制性运动试验并进行气体交换分析。
在第24周时，运动组和对照组患者分别出现以下变化（均值±标准误）；运动持续时间，2.8±0.6分钟和0.5±0.5分钟；峰值耗氧量（VO2），231±54毫升/分钟和58±38毫升/分钟；峰值通气量，12±3升/分钟和-4±3升/分钟；峰值心率，10±4次/分钟和-2±4次/分钟；以及峰值功率输出，20±6瓦和2±5瓦。运动组增加量与对照组变化之间的差异具有显著性（P<0.05）。在运动组患者中，85%的VO2峰值增加在第12周时出现，46%的VO2峰值增加是由峰值心率增加所致。
运动训练对代偿性心力衰竭患者似乎并非禁忌。运动训练可提高运动耐量，表现为VO2峰值、运动持续时间和功率输出增加。这种运动耐量的提高部分是由峰值心率增加所致。
