慢性心力衰竭的康复:需要更多的注意
Bruno Bordoni1, Bruno Morabito2, Vincenzo Myftari3
1Department of Cardiopneumology, Fondazione Don Carlo Gnocchi Onlus IRCCS, 20121 Milano, Italy.
Journal of clinical medicine
|August 28, 2025
概括
鼓舞性肌肉训练 (IMT) 可以显著改善心力衰竭患者的身体能力. 这种方法提高了呼吸功能和整体性能,解决了HF康复中被忽视的隔膜功能障碍.
科学领域:
- 心脏病学
- 呼吸系统医学
- 康复科学
背景情况:
- 慢性心力衰竭的特点是心脏无法满足身体的需求,导致功能衰退和高死亡率.
- 心血管康复,包括有氧和无氧运动,是HF管理的标准.
- 目前的指导方针往往忽略了腹膜的作用和呼吸肌肉训练 (IMT) 在HF康复中.
研究的目的:
- 审查腹膜在心力衰竭中的临床意义.
- 强调鼓舞性肌肉训练 (IMT) 在HF康复方案中的作用.
主要方法:
- 专注于心力衰竭患者的隔膜功能和IMT的文献综述.
- 分析目前有关心脏病康复的国际心脏病指南.
主要成果:
- 隔膜功能障碍是HF患者出现症状的一个重要因素.
- IMT对呼吸和心脏功能以及整体体能起着至关重要的作用.
结论:
- 应将鼓舞性肌肉训练 (IMT) 纳入常规心力衰竭康复中.
- 结合IMT可以增强呼吸功能和改善HF患者的整体体力.
相关概念视频
Cardiomyopathy II: Dilated Cardiomyopathy
21
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
21
Heart Failure V: Medical Management
23
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
23
Heart Failure VI: Adjunct Therapies
27
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
27
Cardiomyopathy V: Interprofessional Care
30
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
30
Heart Failure III: Clinical Manifestations
42
Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
42
Heart Failure VII: Nursing Interventions
139
The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
139


