Willenheimer R, Erhardt L, Cline C, Rydberg E, Israelsson B
Department of Cardiology, Malmö University Hospital, Lund University, Sweden.
Eur Heart J. 1998 May;19(5):774-81. doi: 10.1053/euhj.1997.0853.
Benefit from exercise training in heart failure has mainly been shown in men with ischaemic disease. We aimed to examine the effects of exercise training in heart failure patients < or = 75 years old of both sexes and with various aetiology.
Fifty-four patients with stable mild-to-moderate heart failure were randomized to exercise or control, and 49 completed the study (49% > or = 65 years; 29% women; 24% non-ischaemic aetiology; training, n = 22; controls, n = 27). The exercise programme consisted of bicycle training at 80% of maximal intensity over a period of 4 months. Improvements vs controls were found regarding maximal exercise capacity (6 +/- 12 vs -4 +/- 12% [mean +/- SD], P < 0.01) and global quality-of-life (2 [1] vs 0 [1] units [median ¿inter-quartile range¿], P < 0.01), but not regarding maximal oxygen consumption or the dyspnoea-fatigue index. All of these four variables significantly improved in men with ischaemic aetiology compared with controls (n = 11). However, none of these variables improved in women with ischaemic aetiology (n = 5), or in patients with non-ischaemic aetiology (n = 6). The training response was independent of age, left ventricular systolic function, and maximal oxygen consumption. No training-related adverse effects were reported.
Supervised exercise training was safe and beneficial in heart failure patients < or = 75 years, especially in men with ischaemic aetiology. The effects of exercise training in women and patients with non-ischaemic aetiology should be further examined.
心力衰竭患者运动训练的益处主要在患有缺血性疾病的男性中得到证实。我们旨在研究运动训练对年龄≤75岁、患有各种病因的男女心力衰竭患者的影响。
54例稳定的轻至中度心力衰竭患者被随机分为运动组或对照组,49例完成了研究(49%≥65岁;29%为女性;24%为非缺血性病因;运动组,n = 22;对照组,n = 27)。运动方案包括在4个月的时间内以最大强度的80%进行自行车训练。与对照组相比,运动组在最大运动能力(6±12 vs -4±12%[平均值±标准差],P<0.01)和整体生活质量(2[1] vs 0[1]单位[中位数±四分位数间距],P<0.01)方面有所改善,但在最大耗氧量或呼吸困难-疲劳指数方面没有改善。与对照组相比(n = 11),所有这四个变量在患有缺血性病因的男性中均有显著改善。然而,在患有缺血性病因的女性中(n = 5)或非缺血性病因的患者中(n = 6),这些变量均未改善。训练反应与年龄、左心室收缩功能和最大耗氧量无关。未报告与训练相关的不良反应。
在年龄≤75岁的心力衰竭患者中,监督下的运动训练是安全且有益的,尤其是在患有缺血性病因的男性中。运动训练对女性和非缺血性病因患者的影响应进一步研究。