Isolated knee extensor exercise training improves skeletal muscle vasodilation, blood flow, and functional capacity in patients with HFpEF.
Isolated knee extensor exercise training improves skeletal muscle vasodilation, blood flow, and functional capacity in patients with HFpEF.
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DOI：
10.14814/phy2.15419
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发表时间：
2022-08
影响因子：
2.5
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中科院分区：
文献类型：
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HFpEF患者出现严重的运动不耐受，部分原因是外周血管和骨骼肌损伤。针对外周适应运动训练的干预措施可能会逆转血管功能障碍，增加外周氧化能力，并改善HFpEF的功能能力。确定8周的单独膝关节伸展运动（KE）训练是否会逆转HFpEF患者的血管功能障碍、外周氧利用率和运动能力。9名HFpEF患者（66 ± 5岁，6名女性）在IKE训练（3次/周，30分钟/腿）前后进行分级IKE运动（5、10和15 W）和最大运动测试（自行车测力计）。股血流（超声）和腿部血管传导性（LVC;血管舒张指数）在分级IKE运动。在分级最大循环运动期间测量峰值肺氧摄取量（V_（O2）;道格拉斯袋）和心输出量（QC;乙炔再呼吸）。在15 W IKE运动期间，IKE训练改善了LVC（前：810 ± 417，后：1234 ± 347 ml/min/100 mmHg; p = 0.01），并使功能能力增加了13%（踏车测力计期间的峰值V ~ O2;前：12.4 ± 5.2，后：14.0 ± 6.0 ml/min/kg; p = 0.01）。峰值V ~ O2的改善与Q ~ c的变化无关（治疗前：12.7 ± 3.5，治疗后：13.2 ± 3.9 L/min; p = 0.26），主要是由于a-vO 2差异增加（治疗前：10.3 ± 1.6，治疗后：11.0 ± 1.7; p = 0.02）。IKE训练改善HFpEF患者的血管舒张和功能能力。旨在增加外周氧化能力的运动干预可能是HFpEF患者的有效治疗选择。本研究证实了HFpEF患者的残余血管可塑性。IKE训练可能对传统有氧训练期间运动能力严重外周限制或呼吸困难的患者有益。
Patients with HFpEF experience severe exercise intolerance due in part to peripheral vascular and skeletal muscle impairments. Interventions targeting peripheral adaptations to exercise training may reverse vascular dysfunction, increase peripheral oxidative capacity, and improve functional capacity in HFpEF. Determine if 8 weeks of isolated knee extension exercise (KE) training will reverse vascular dysfunction, peripheral oxygen utilization, and exercise capacity in patients with HFpEF. Nine HFpEF patients (66 ± 5 years, 6 females) performed graded IKE exercise (5, 10, and 15 W) and maximal exercise testing (cycle ergometer) before and after IKE training (3x/week, 30 min/leg). Femoral blood flow (ultrasound) and leg vascular conductance (LVC; index of vasodilation) were measured during graded IKE exercise. Peak pulmonary oxygen uptake (V̇O2; Douglas bags) and cardiac output (QC; acetylene rebreathe) were measured during graded maximal cycle exercise. IKE training improved LVC (pre: 810 ± 417, post: 1234 ± 347 ml/min/100 mmHg; p = 0.01) during 15 W IKE exercise and increased functional capacity by 13% (peak V̇O2 during cycle ergometry; pre:12.4 ± 5.2, post: 14.0 ± 6.0 ml/min/kg; p = 0.01). The improvement in peak V̇O2 was independent of changes in Q̇c (pre:12.7 ± 3.5, post: 13.2 ± 3.9 L/min; p = 0.26) and due primarily to increased a‐vO2 difference (pre: 10.3 ± 1.6, post: 11.0 ± 1.7; p = 0.02). IKE training improved vasodilation and functional capacity in patients with HFpEF. Exercise interventions aimed at increasing peripheral oxidative capacity may be effective therapeutic options for HFpEF patients. This study demonstrates residual vascular plasticity in patients with HFpEF. IKE training may be beneficial for patients with severe peripheral limitations to exercise capacity or dyspnea during traditional aerobic training.