Exercise training restores aerobic capacity and energy transfer systems in heart failure treated with losartan
Exercise training restores aerobic capacity and energy transfer systems in heart failure treated with losartan
复制标题
DOI：
10.1016/j.cardiores.2007.06.008
复制
发表时间：
2007-10-01
影响因子：
10.8
通讯作者：
Ellingsen, Oyvind
中科院分区：
文献类型：
--
作者：
Kemi, Ole Johan;Hoydal, Morten Andre;Ellingsen, Oyvind
目的：临床和实验研究表明，运动训练可以改善心力衰竭患者的有氧能力和心脏功能，即使是在使用血管紧张素抑制剂和β受体阻滞剂进行最佳治疗的患者中，但细胞机制尚未完全了解。由于心肌功能不全是经常与受损的能量状态，本研究的目的是评估运动训练和氯沙坦对心肌系统的能量生产和转移在heartfail.Methods的影响：最大摄氧量，心脏功能和能量代谢进行了评估后，在心力衰竭的女性SD大鼠冠状动脉结扎引起的心肌梗死。梗死后一周开始氯沙坦治疗，四周后开始运动训练，无论是单独干预还是联合干预。结果：心力衰竭，证实左心室舒张压> 15毫米汞柱和收缩压峰值下降>20毫米汞柱，与40%的有氧能力降低和参与能量代谢的酶显着减少。联合治疗对有氧能力和心室压力特性的改善效果最好。运动训练完全恢复有氧能力，部分或完全恢复肌酸和腺苷酸激酶，而氯沙坦单独进一步降低这些酶。与此相反，氯沙坦降低左心室舒张压，而运动训练有中性effect.Conclusion：运动训练显着改善心肌梗死后的有氧能力和心功能，无论是单独或联合血管紧张素抑制剂。这两种干预措施似乎通过互补机制起作用;而运动训练主要在能量转移水平恢复心脏能量代谢，氯沙坦通过降低充盈压和后负荷来减轻心脏负荷。(C)2007年欧洲心脏病学会。Elsevier B. V.出版，保留所有权利。
Objective: Clinical and experimental studies demonstrate that exercise training improves aerobic capacity and cardiac function in heart failure, even in patients on optimal treatment with angiotensin inhibitors and beta-blockers, but the cellular mechanisms are incompletely understood. Since myocardial dysfunction is frequently associated with impaired energy status, the aim of this study was to assess the effects of exercise training and losartan on myocardial systems for energy production and transfer in heart failure.Methods: Maximal oxygen uptake, cardiac function and energy metabolism were assessed in heart failure after a myocardial infarction induced by coronary artery ligation in female Sprague-Dawley rats. Losartan was initiated one week after infarction and exercise training after four weeks, either as single interventions or combined. Animals were sacrificed 12 weeks after surgery.Results: Heart failure, confirmed by left ventricular diastolic pressure > 15 mmHg and by >20 mmHg drop in peak systolic pressure, was associated with 40% lower aerobic capacity and significant reductions in enzymes involved in energy metabolism. Combined treatment yielded best improvement of aerobic capacity and ventricular pressure characteristics. Exercise training completely restored aerobic capacity and partly or fully restored creatine and adenylate kinases, whereas losartan alone further reduced these enzymes. In contrast, losartan reduced left ventricle diastolic pressure, whereas exercise training had a neutral effect.Conclusion: Exercise training markedly improves aerobic capacity and cardiac function after myocardial infarction, either alone or in combination with angiotensin inhibition. The two interventions appear to act by complementary mechanisms; whereas exercise training restores cardiac energy metabolism, mainly at the level of energy transfer, losartan unloads the heart by lowering filling pressure and afterload. (C) 2007 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.