Effects of home-based exercise training on neurovascular control in patients with heart failure
Effects of home-based exercise training on neurovascular control in patients with heart failure
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DOI：
10.1016/j.ejheart.2006.02.009
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发表时间：
2006-12-01
影响因子：
18.2
通讯作者：
Barretto, Antonio C. Pereira
中科院分区：
文献类型：
--
作者：
de Mello Franco, Fabio Gazelato;Santos, Amilton C.;Barretto, Antonio C. Pereira
背景：家庭运动训练对心衰患者神经血管控制的影响尚不清楚。目的：验证家庭训练是否能维持监督训练后肌肉交感神经活动（MSNA）和前臂血管阻力（FVR）的降低。方法和结果：29例患者（54±1.9岁，EF < 40%）随机分为两组：未训练对照组（n = 12）和运动训练组（n = 17）。两组均进行了生活质量（QoL）、MSNA和前臂血流量的评估。锻炼组先进行为期4个月的有监督的训练，然后进行为期4个月的家庭训练。在最初4个月的训练后，与未训练组相比，运动组患者的峰值VO2显著增加，NISNA显著降低，但在4个月的家庭训练中没有保持这种情况。相比之下，在家训练期间，FVR的降低（56 +/- 3 vs. 46 +/- 4 vs. 40 +/- 2 U, p =0.008）和生活质量的改善在监督训练期间保持不变。结论：在有监督的训练之后，以家庭为基础的训练是一种安全的策略，可以维持慢性心力衰竭患者生活质量的改善和FVR的降低，但从VO2峰值或神经肿瘤激活降低的估计来看，这是一种不足以维持健康的策略。(c) 2006年欧洲心脏病学会。Elsevier B.V.版权所有。
Background: The effect of home-based exercise training on neurovascular control in heart failure patients is unknown.Aims: To test the hypothesis that home-based training would maintain the reduction in muscle sympathetic nerve activity (MSNA) and forearm vascular resistance (FVR) acquired after supervised training.Methods and results: Twenty-nine patients (54 +/- 1.9 years, EF < 40%) were randomised into two groups: untrained control (n = 12) and exercise trained (n = 17). Both groups underwent assessment of Quality of Life (QoL), MSNA, and forearm blood flow. The exercise group underwent a 4-month supervised training program followed by 4 months of home-based training. After the initial 4 months of training, patients in the exercise group showed a significant increase in peak VO2 and reduction in NISNA, compared to the untrained group, but this was not maintained during 4 months of home-based training. In contrast, the decrease in FVR (56 +/- 3 vs. 46 +/- 4 vs. 40 +/- 2 U, p =0.008) and the improvement in QOL that were achieved during supervised training were maintained during home-based training.Conclusions: Home-based training following supervised training is a safe strategy to maintain improvements in QoL and reduction in FVR in chronic heart failure patients, but is an inadequate strategy to maintain fitness as estimated by peak VO2 or reduction in neurchumoral activation. (c) 2006 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.