Optimizing Outcomes in Cardiac Rehabilitation: The Importance of Exercise Intensity.
Optimizing Outcomes in Cardiac Rehabilitation: The Importance of Exercise Intensity.
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DOI：
10.3389/fcvm.2021.734278
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发表时间：
2021
影响因子：
3.6
通讯作者：
Olson TP
中科院分区：
文献类型：
--
作者：
Taylor JL;Bonikowske AR;Olson TP
基于运动的心脏康复（CR）是国际上公认的1级临床实践推荐，用于特定心血管疾病和心力衰竭患者的射血分数降低。在过去的十年里，几项荟萃分析引发了关于基于运动的CR降低全因死亡率和心血管死亡率的有效性的争论。在这些荟萃分析中强调的一个共同主题是，在CR项目中，关于运动处方方法的异质性和/或缺乏细节。目前，国际上对CR的运动处方尚无共识，各国推荐的运动强度也存在很大差异，从轻、中强度到中强度再到中等强度。由于心肺适能[峰值摄氧量（vo2峰值）]是冠心病和心力衰竭患者死亡率的重要预测指标，因此，优化心肺适能和运动能力改善的运动处方是CR规划效果的关键考虑因素。这篇综述将研究在CR中使用高强度有氧运动的证据，包括高强度间歇训练的作用。本文将重点讨论冠心病和心力衰竭患者进行中等强度运动训练对肺、心脏、血管和骨骼肌系统的有益生理适应。此外，本综述将提出不同的间歇运动方案（如短时间或长时间间歇训练）和运动进展模型如何影响中枢和外周生理适应。重要的是，本综述的一个重点是提供临床相关的建议和策略，以优化运动强度处方，同时最大限度地提高参加CR项目的患者的安全性。
Exercise based cardiac rehabilitation (CR) is recognized internationally as a class 1 clinical practice recommendation for patients with select cardiovascular diseases and heart failure with reduced ejection fraction. Over the past decade, several meta-analyses have generated debate regarding the effectiveness of exercise-based CR for reducing all-cause and cardiovascular mortality. A common theme highlighted in these meta-analyses is the heterogeneity and/or lack of detail regarding exercise prescription methodology within CR programs. Currently there is no international consensus on exercise prescription for CR, and exercise intensity recommendations vary considerably between countries from light-moderate intensity to moderate intensity to moderate-vigorous intensity. As cardiorespiratory fitness [peak oxygen uptake (VO2peak)] is a strong predictor of mortality in patients with coronary heart disease and heart failure, exercise prescription that optimizes improvement in cardiorespiratory fitness and exercise capacity is a critical consideration for the efficacy of CR programming. This review will examine the evidence for prescribing higher-intensity aerobic exercise in CR, including the role of high-intensity interval training. This discussion will highlight the beneficial physiological adaptations to pulmonary, cardiac, vascular, and skeletal muscle systems associated with moderate-vigorous exercise training in patients with coronary heart disease and heart failure. Moreover, this review will propose how varying interval exercise protocols (such as short-duration or long-duration interval training) and exercise progression models may influence central and peripheral physiological adaptations. Importantly, a key focus of this review is to provide clinically-relevant recommendations and strategies to optimize prescription of exercise intensity while maximizing safety in patients attending CR programs.
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DOI：
10.1249/00005768-198205000-00012
发表时间：
1982-01-01
期刊：
MEDICINE AND SCIENCE IN SPORTS AND EXERCISE
影响因子：
--
作者：
BORG, GAV
通讯作者：
BORG, GAV
影响因子：
3.7
作者：
Bacon, Andrew P.;Carter, Rickey E.;Joyner, Michael J.
通讯作者：
Joyner, Michael J.
影响因子：
2.8
作者：
Bensimhon, Daniel R.;Leifer, Eric S.;Russell, Stuart D.
通讯作者：
Russell, Stuart D.
DOI：
10.1161/circheartfailure.112.000157
发表时间：
2013-05
期刊：
Circulation. Heart failure
影响因子：
--
作者：
Chatterjee NA;Murphy RM;Malhotra R;Dhakal BP;Baggish AL;Pappagianopoulos PP;Hough SS;Semigran MJ;Lewis GD
通讯作者：
Lewis GD
影响因子：
3
作者：
Casillas, Jean-Marie;Joussain, Charles;Benaim, Charles
通讯作者：
Benaim, Charles