Exercise training in older patients with heart failure and preserved ejection fraction: a randomized, controlled, single-blind trial.
Exercise training in older patients with heart failure and preserved ejection fraction: a randomized, controlled, single-blind trial.
复制标题
DOI：
10.1161/circheartfailure.110.958785
复制
发表时间：
2010-11
期刊：
影响因子：
--
通讯作者：
Little WC
中科院分区：
文献类型：
--
作者：
Kitzman DW;Brubaker PH;Morgan TM;Stewart KP;Little WC
左心室射血分数保留的心力衰竭 (HFPEF) 是老年人群中最常见的心力衰竭形式。运动不耐受是 HFPEF 患者的主要慢性症状，也是其生活质量 (QOL) 下降的重要决定因素。运动训练 (ET) 可改善射血分数降低的心力衰竭患者的运动不耐受和生活质量。然而，ET 对 HFPEF 的影响尚未在随机对照试验中得到检验。这是一项随机、注意力对照、单盲研究，对 53 名患有孤立性 HFPEF（EF ≥ 50%，且无明显冠状动脉、瓣膜或肺部疾病）的老年人（平均年龄 70±6 岁；范围 60-82；46 名女性，7 名男性）进行为期 16 周的医学监督 ET（每周 3 天）运动不耐受和生活质量研究。注意力控制者每两周接到一次后续电话。 46 名患者完成了研究（24 名 ET，22 名对照）。 ET 组参加锻炼的情况非常好（88%；范围 64-100%）。没有与试验相关的不良事件。与对照组相比，ET 组的主要结果峰值运动摄氧量显着增加（13.8±2.5 至 16.1±2.6 ml/kg/min，变化 2.3±2.2 ml/kg/min vs. 12.8±2.6 至 12.5±3.4，变化 -0.3±2.1 ml/kg/min）（p=0.0002）。峰值功率输出、运动时间、6 分钟步行距离和通气无氧阈值均有显着改善（所有 p<0.002）。身体生活质量得分有所改善（p = 0.03），但总得分没有改善（p = 0.11）。 ET 可改善老年 HFPEF 患者的峰值和次最大运动能力。
HF with preserved left ventricular ejection fraction (HFPEF) is the most common form of HF in the older population. Exercise intolerance is the primary chronic symptom in HFPEF patients and is a strong determinant of their reduced quality of life (QOL). Exercise training (ET) improves exercise intolerance and QOL in HF patients with reduced ejection fraction. However, the effect of ET in HFPEF has not been examined in a randomized, controlled trial. This was a randomized, attention-controlled, single blind study of 16 weeks of medically supervised ET (3 days per week) on exercise intolerance and QOL in 53 elderly (mean age 70±6 yrs; range 60–82; 46 women, 7 men) patients with isolated HFPEF (EF ≥ 50%, and no significant coronary, valvular, or pulmonary disease). Attention controls received biweekly follow-up telephone calls. Forty-six patients completed the study (24 ET, 22 controls). Attendance at exercise sessions in the ET group was excellent (88%; range 64–100%). There were no trial-related adverse events. Peak exercise oxygen uptake, the primary outcome, increased significantly in the ET group compared to the control group (13.8±2.5 to 16.1±2.6 ml/kg/min, change 2.3±2.2 ml/kg/min vs. 12.8±2.6 to 12.5±3.4, change −0.3±2.1 ml/kg/min) (p=0.0002). There were significant improvements in peak power output, exercise time, 6 minute walk distance, and ventilatory anaerobic threshold (all p<0.002). There was improvement in the physical QOL score (p=0.03) but not the total score (p=0.11). ET improves peak and submaximal exercise capacity in older patients with HFPEF.