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Un año de entrenamiento físico revertirá la rigidez miocárdica ventricular izquierda anormal en pacientes con
Michinari Hieda1,2,3, Satyam Sarma1,2, Christopher M Hearon1,2
1Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas (M.H., S.S., C.M.H., J.P.M., K.A.D., M.S., D.P., S.L., M.M., B.D.L.).
Circulation
|September 20, 2021
Resumen
El ejercicio de alta intensidad redujo significativamente la rigidez del miocardio del ventrículo izquierdo (LV) en pacientes con hipertrofia de LV y biomarcadores cardíacos elevados. Esto sugiere que el ejercicio puede prevenir la insuficiencia cardíaca futura con la fracción de eyección preservada.
Área de la Ciencia:
- Cardiología
- Fisiología del ejercicio
- Investigación de la insuficiencia cardíaca
Sus antecedentes:
- Las personas de mediana edad con hipertrofia ventricular izquierda (LV) y biomarcadores cardíacos elevados enfrentan un mayor riesgo de insuficiencia cardíaca con fracción de eyección preservada (HFpEF).
- Se sabe que el entrenamiento físico prolongado revierte el endurecimiento de LV en el envejecimiento saludable, pero se desconoce su efecto en pacientes de alto riesgo.
Objetivo del estudio:
- Investigar si un año de entrenamiento físico prolongado puede normalizar la rigidez miocárdica LV en pacientes con hipertrofia LV y biomarcadores cardíacos elevados.
- Evaluar el impacto del ejercicio en la función cardíaca en individuos con alto riesgo de HFpEF.
Principales métodos:
- Un ensayo controlado aleatorio prospectivo en el que participaron 46 pacientes con hipertrofia de LV y biomarcadores cardíacos elevados.
- Los pacientes fueron asignados a un año de entrenamiento físico de alta intensidad (n=30) o a un grupo de control de atención (n=16).
- La rigidez miocárdica de LV se determinó mediante cateterismo del corazón derecho y ecocardiografía 3D durante la manipulación de precarga, calculando la rigidez a partir de la relación presión-volumen diastólica final de LV.
Principales resultados:
- Un año de entrenamiento físico aumentó significativamente la aptitud cardiorrespiratoria (VO2 max) en un 21% (P< 0, 0001) en comparación con los controles.
- El entrenamiento con ejercicios redujo significativamente la rigidez miocárdica LV (línea de base 0,062±0,020 a 0,031±0,009, P=0,001) en comparación con los controles.
- No se observaron cambios significativos en el VO2 máximo ni en la rigidez miocárdica LV en el grupo de control.
Conclusiones:
- Un año de ejercicio de alta intensidad redujo efectivamente la rigidez miocárdica de LV en pacientes con hipertrofia de LV y biomarcadores cardíacos elevados.
- El entrenamiento físico puede ofrecer una estrategia protectora contra el desarrollo de insuficiencia cardíaca con fracción de eyección preservada en esta población de alto riesgo.
- PruebasClínicas.gov Identificador: NCT03476785.
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