高强度间歇训练与通过在心力衰竭患者中调解左心室重塑以减少和中程射出分数的患者中改善10年生存率有关
Chih-Chin Hsu1,2, Tieh-Cheng Fu1,3, Chao-Hung Wang2,3
1Department of Physical Medicine and Rehabilitation Keelung Chang Gung Memorial Hospital Keelung Taiwan.
Journal of the American Heart Association
|January 19, 2024
概括
高强度间歇训练 (HIIT) 通过逆转左心室重塑来改善心力衰竭患者的长期存活率. 这种运动干预提供了显著的好处,特别是对于那些射出率低或中等的人来说.
科学领域:
- 心脏病学 心脏病学
- 运动生理学 运动生理学
- 临床医学 临床医学
背景情况:
- 心力衰竭 (HF) 涵盖了影响患者预后的各种表型.
- 左心室 (LV) 改造是高血压患者结果的关键决定因素.
- 在HF患者中,长期存活仍然是一个关键的临床挑战.
研究的目的:
- 评估高强度间歇训练 (HIIT) 对LV改造的影响.
- 评估接受HIIT的HF患者的10年生存率.
- 为了研究运动,LV重塑和不同HF表型的死亡率之间的关系.
主要方法:
- 一项纵向研究对214名心力衰竭患者进行了长达10年的随访.
- 患者被分为HIIT (n=96) 和指南导向医学治疗 (GDMT) 组 (n=118).
- 肝炎表型是根据LV喷射分数 (EF) 定义的:减少 (<40%),中等范围 (≥40%至<50%),并保留 (≥50%).
- 记录了峰值氧气消耗 (O2峰值),LV几何和死亡率.
- 因果调解分析探讨了LV重塑在HIIT对生存的影响中的LV重塑的作用.
主要成果:
- 总体10年生存率在HIIT组 (80.3%) 与GDMT组 (68.6%) (P=0.015) 相比显著更高.
- 改善的O2峰值,减少分钟通风/二氧化碳生产斜率,以及减少LV终端-透气直径与更好的生存率有关.
- 在HF患者中,HIIT显著改善了低EF (P=0.044) 和中等EF (P=0.036) 的HF患者的10年生存率.
- 在所有HF患者 (P<0.001) 和LVEF<50% (P=0.006) 的患者中,LV终端-透析直径调解了HIIT和10年死亡率之间的关联.
结论:
- 通过HIIT扭转LV重塑是提高HF患者10年生存率的重要媒介.
- HIIT显示出直接的生存益处,特别是在LVEF<50%的HF患者中.
- 这些发现支持HIIT作为一种有价值的治疗策略,用于管理心力衰竭并改善长期结果.
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