对于心力衰竭和保存喷射小部分的患者进行运动训练. 一个叙事审查
Giuseppe Caminiti1, Maurizio Volterrani2, Ferdinando Iellamo3
1Department of Human Science and Promotion of Quality of Life, San Raffaele Open University, Rome; Cardiology Rehabilitation Unit, IRCCS San Raffaele, Rome. giuseppe.caminiti@uniroma5.it.
概括
心脏衰竭与保存的喷射分数 (HFpEF) 是常见的,特别是在老年妇女中. 监督运动训练 (ET) 可能会改善症状和生活质量,但需要更多的研究.
科学领域:
- 心脏病学 心脏病学
- 运动生理学 运动生理学
背景情况:
- 保存喷射分数 (HFpEF) 的心力衰竭影响高达50%的心力衰竭病例,主要是老年人和女性.
- 由于高并发症负担 (例如,功能衰竭,心房动,肥胖症),使病理生理学和症状复杂化,因此HFpEF管理是复杂的.
- 运动不耐受是HFpEF的一个关键症状,源于中部和外围氧气运输和利用的损害.
研究的目的:
- 审查运动不耐受性在HFpEF中的作用.
- 综合当前关于HFpEF患者运动训练 (ET) 益处的知识.
- 突出需要进一步研究HFpEF的基于运动的干预措施.
主要方法:
- 文献综述综合了HFpEF中关于运动不耐受和ET的现有研究.
- 关于ET在改善HFpEF患者的运动耐受性和生活质量方面的疗效的证据分析.
- 识别当前研究中的差距,并呼吁进行更大,更精心设计的研究.
主要成果:
- 运动不耐受是HFpEF的一个重要,多因素的问题.
- 监督ET显示了提高HFpEF患者的运动耐受性和生活质量的潜力.
- 目前的证据有限,小规模研究的结果各不相同.
结论:
- 运动不耐受是HFpEF的一个关键因素.
- 监督ET可能为HFpEF患者提供好处,但证据稀少.
- 更大,更强大的研究是必要的,以证实ET在改善HFpEF结果方面的有效性.
相关概念视频
01:20Exercise and Cardiovascular Response
765
Exercise significantly impacts cardiovascular response, which is crucial for understanding patient health and designing effective treatment plans.
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...
765
01:17Exercise and Cardiac Output
967
Regular physical activity is essential for maintaining cardiovascular health, with aerobic exercises being particularly effective. According to the American Heart Association, 150 minutes of moderate to intense aerobic exercise per week is recommended for a healthy heart. Aerobic activities may include brisk walking, running, bicycling, cross-country skiing, and swimming, ideally performed three to five times per week.
Sustained exercise increases the muscles' oxygen demand, which can be...
Sustained exercise increases the muscles' oxygen demand, which can be...
967
01:17Pathophysiology of Heart Failure
1.5K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.5K
01:26Heart Failure Drugs: Inotropic Agents
555
Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
555
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
413
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
413
01:22Heart Failure Drugs: β-Blockers
332
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
332