慢性心不全患者の左心室機能と周辺抵抗に対する運動トレーニングの効果:ランダム化試験

R Hambrecht¹, S Gielen, A Linke

¹Klinik für Innere Medizin/Kardiologie, Universität Leipzig, Herzzentrum GmbH, Russenstrasse 19, 04289 Leipzig, Germany. hamr@server3.medizin.uni-leipzig.de

JAMA

|June 24, 2000

まとめ

運動トレーニングは,慢性心不全の患者の運動能力と心機能を大幅に改善します. この介入は,周辺の抵抗を軽減し,脳卒中量を増加させ,心臓のサイズを小さくします.

科学分野:

心臓病学心臓病学
運動生理学運動生理学
心不全管理について

背景:

運動トレーニングは,内皮機能と有酸素代謝を通じて慢性心不全の能力を改善します.
心不全における運動トレーニングの中央血液動力学的効果は十分に理解されていません.

研究の目的:

安定した慢性心不全患者の左心室 (LV) 機能と血動力学的反応に対する運動トレーニングの影響を評価する.

主な方法:

73人の慢性心不全の男性患者 (年齢 ≤70) を対象とした予期的なランダム化試験.
介入: 6ヶ月のエルゴメーター運動訓練対対照群.
成果測定:エルゴスピロメトリー,中央血動力学 (熱調和),エコーカルディオグラフィー (LV機能と寸法).

主要な成果:

運動グループは,機能的クラス,運動能力,および休息時の脳卒中量の改善を示しました.
運動グループでは,LVエジェクション分数 (0.30から0.35) の有意な増加.
トータル・ペリフェラル・レジスタンス (TPR) の減少と,トレーニングを受けたグループのピーク運動中の脳卒中量の増加.

結論:

運動トレーニングは,慢性心不全の周辺抵抗を減少させます.
ストロークの容量の有意な改善と心臓病の減少につながります.

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