Digenio A G, Cantor A, Noakes T D, Cloete L, Mavunda D, Esser J D
Johannesburg Cardiac Rehabilitation Centre, Department of Health and Housing, Israel.
S Afr Med J. 1996 Sep;86(9):1106-9.
To evaluate the effects of an exercise training programme on patients with chronic left ventricular dysfunction.
Intervention, before and after the trial.
Johannesburg Cardiac Rehabilitation Centre, a phase III community-based cardiac rehabilitation facility.
A consecutive sample of 28 patients who were recovering from acute myocardial infarction and who had a left ventricular ejection fraction of 30% or less. Twenty two patients completed the exercise training programme.
A medically supervised exercise training programme of 6 months' duration. Type of exercise: walking, jogging or cycling. Intensity: 65-85% of the patient's maximal heart rate achieved during treadmill testing.
30-45 minutes. Frequency: 3 times a week. Patients who attended fewer than 60% of all prescribed sessions were considered drop-outs.
Haemodynamic, left ventricular function and effort tolerance parameters before and after training.
Patients who completed the exercise training programme showed a significant improvement in maximal exercise capacity and a significant reduction in their cardiovascular demands during submaximal exercise. Peak oxygen consumption was increased by 12% after training (19.4 +/- 3 v. 21.8 +/- 4.8 ml/kg/min; P < 0.05) and exercise time to exhaustion by 33% (527 +/- 171 v. 700 +/- 186 seconds; P < 0.001). The double product at the same submaximal workload was significantly reduced (214 +/- 52 v. 194 +/- 44 beats/min x mmHg x 10(2); P < 0.05). These benefits were achieved without any adverse effects on resting (25.4 +/- 5 v. 28.5 +/- 7.9%; P < 0.05) or exercise (27.3 +/- 7.7 v. 29.9 +/- 9.5%; P > 0.05) left ventricular ejection fraction.
Our results show that patients with chronic left ventricular dysfunction can benefit from an exercise training programme and that those benefits can be achieved without risk of further deterioration in left ventricular function. Physical training constitutes another therapeutic option which could be added to the comprehensive management of these patients.
评估运动训练计划对慢性左心室功能不全患者的影响。
试验前后的干预研究。
约翰内斯堡心脏康复中心，一个基于社区的Ⅲ期心脏康复机构。
连续选取28例急性心肌梗死后正在康复且左心室射血分数为30%或更低的患者。22例患者完成了运动训练计划。
一项为期6个月、由医学监督的运动训练计划。运动类型：步行、慢跑或骑自行车。强度：达到患者在跑步机测试中最大心率的65% - 85%。
30 - 45分钟。频率：每周3次。参加规定课程少于60%的患者被视为退出。
训练前后的血流动力学、左心室功能和耐力参数。
完成运动训练计划的患者最大运动能力有显著改善，次最大运动时心血管需求显著降低。训练后峰值耗氧量增加了12%（19.4±3对21.8±4.8毫升/千克/分钟；P<0.05），力竭运动时间增加了33%（527±171对700±186秒；P<0.001）。在相同次最大工作量时的双乘积显著降低（214±52对194±44次/分钟×毫米汞柱×10²；P<0.05）。这些益处的取得并未对静息（25.4±5对28.5±7.9%；P<0.05）或运动时（27.3±7.7对29.9±9.5%；P>0.05）的左心室射血分数产生任何不良影响。
我们的结果表明，慢性左心室功能不全患者可从运动训练计划中获益，且这些益处的实现不会有左心室功能进一步恶化的风险。体育锻炼是另一种治疗选择，可纳入这些患者的综合管理中。
