心不全患者におけるエアロビックインターバルトレーニングと中程度の連続トレーニングの優れた心血管効果:ランダム化研究
Ulrik Wisløff1, Asbjørn Støylen, Jan P Loennechen
1Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Olav Kyrres gt. 9, 7489 Trondheim, Norway. ulrik.wisloff@ntnu.no
Circulation
|June 6, 2007
まとめ
高強度インターバルトレーニングは,心臓機能の有意な改善と,心不全の高齢患者の左心室リフォームを逆行させました. 適度な強度の運動も生活の質を向上させましたが,高強度のトレーニングは優れた結果をもたらしました.
科学分野:
- 心臓病学 心臓病学
- 運動生理学 運動生理学
- ゲリアトリクス ゲリアトリクス
背景:
- 慢性心不全 (CHF) の症状は,運動トレーニングによって軽減されますが,有益な適応のための最適な強度は依然として議論されています.
- CHFの発生率は年齢とともに増加しますが,高齢者 (>70歳) は研究から除外されることが多いです.
- この研究では,心筋梗塞後のCHFの高齢患者における中程度の対高度の運動強度が調査されました.
研究 の 目的:
- 中等強度の継続トレーニング (MICT) とエアロビックインターバルトレーニング (AIT) の心臓血管機能および心臓発作後の心不全の高齢患者の予後に対する効果を比較する.
- 左心室 (LV) の改造,エアロビック能力,内皮機能,および生活の質に対する運動の強度の影響を評価する.
主な方法:
- 安定した心不全の27人の高齢患者 (平均年齢75.5歳) は,MICT (ピーク心拍数70%),AIT (ピーク心拍数95%) または対照群の3つのグループにランダムに分けられました.
- 参加者は12週間のトレーニング (週3回) を受け,最適な医療治療と併せて受けました.
- 心血管機能,LVリモデリング,内皮機能,ミトコンドリア機能,生活の質が評価されました.
主要な成果:
- AITは,MICTと比較して,ピーク酸素消費 (VO2ピーク) (46%対14%,P<0.001) で著しく大きな改善をもたらしました.
- AITが誘発したリバースLVリモダリングにより,LVのエンド・ダイアストリックとエンド・シストリック量はそれぞれ18%と25%減少し,LVのエジェクション分数は35%増加しました.
- AITは,内皮機能とミトコンドリア機能のより大きな改善を示し,両方の運動グループは生活の質のスコアを改善しました.
結論:
- 運動の強度は,LVの改造を逆転させ,心臓発作後の心不全患者の有酸素能力,内皮機能,生活の質を向上させる上で極めて重要です.
- 高強度インターバルトレーニングは,この高齢者のコホートにおける中等強度トレーニングと比較して,心血管機能と再構築に優れた利点を示しました.
- この発見は,心不全の高齢者のための心臓リハビリテーションプログラムにおいて,調整された運動の強さを支持しています.
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