Response by Brubaker et al to Letter Regarding "A Randomized, Controlled Trial of Resistance Training Added to Caloric Restriction Plus Aerobic Exercise Training in Obese Heart Failure With Preserved Ejection Fraction".
Response by Brubaker et al to Letter Regarding "A Randomized, Controlled Trial of Resistance Training Added to Caloric Restriction Plus Aerobic Exercise Training in Obese Heart Failure With Preserved Ejection Fraction".
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Brubaker 等人对关于“在保留射血分数的肥胖性心力衰竭中添加热量限制加有氧运动训练的阻力训练的随机对照试验”的信件的回复。
DOI：
10.1161/circheartfailure.123.010419
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Kitzman,DalaneW
中科院分区：
文献类型：
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作者：
Brubaker,PeterH;Nelson,WBenjamin;Kitzman,DalaneW
我们感谢Kambic等人对我们最近试验中使用的阻力训练（RT）方案的评论。1然而，我们报告的研究结果并不支持他们的声明，即“训练20周后，RT对最大有氧能力、下肢肌肉力量和生活质量没有额外的益处”。正如我们的中心图2所强调的，20周的RT确实导致下肢肌肉力量以及骨骼肌质量的显著改善，证明了我们在这些患有肥胖心力衰竭和射血分数保留（HFpEF）的老年人中使用的RT方案的有效性。在肥胖HFpEF老年患者中，将正式RT添加到热量限制饮食和有氧运动训练干预中的盲法试验。我们采用了一种标准的、现行的、基于指南的RT方案2，该方案非常适合这些老年、虚弱的HF患者，并采用了多组分（热量限制饮食+有氧运动训练+ RT）干预。它开始于相对较低的RT强度，并逐渐进展，以尽量减少受伤、过度疲劳和潜在脱落的风险。进行的RT组数（共12组）旨在控制RT花费的时间（约20分钟），因为该部分是在完成约40分钟的有氧运动训练后进行的。尽管在整个试验期间，RT相对强度维持在1次重复最大值的40%至50%的中等水平，但每4周重复1次重复最大值测试程序，以评估强度增加并确保进展和最佳RT水平。2我们的试验结果证明了增加RT在增加下肢力量和改善骨骼肌质量方面的有效性，以及在这些患有肥胖HFpEF的老年患者中使用的安全性，
We appreciate the comments of Kambic et al regarding the resistance training (RT) protocol we utilized in our recent trial. 1 However, our reported findings do not support their statement of “no additional benefits of RT on maximal aerobic capacity, lower limb muscle strength, and quality of life after 20 weeks of training.” As highlighted in our central Figure 2, 20 weeks of RT did result in significant improvements in lower extremity muscle strength, as well as skeletal muscle quality, demonstrating the effectiveness of the RT protocol we utilized in these older adults with obese heart failure and preserved ejection fraction (HFpEF).This1 is the first published randomized, blinded trial to add formal RT to an intervention of a caloric-restricted diet and aerobic exercise training in older patients with obese HFpEF. We utilized a standard, current, guidelinebased RT protocol2 that was well suited to these older, frail patients with HF, and the multicomponent (caloricrestricted diet+ aerobic exercise training+ RT) intervention. It began with a relatively low RT intensity and progressed gradually to minimize risk for injury, excessive fatigue, and potential dropout The number of RT sets performed (12 total) was designed to control the time spent in RT (≈ 20 minutes) since this component was being performed after the completion of≈ 40 minutes of aerobic exercise training. Although the RT relative intensity was maintained throughout the trial at a moderate level of 40% to 50% of the 1 repetition maximum, the 1 repetition maximum testing procedure was repeated every 4 weeks to assess strength gains and ensure progression and optimal RT levels. 2 Our trial result demonstrates both the effectiveness of adding RT in increasing lower extremity strength and improving skeletal muscle quality, as well the safety of utilizing in these older patients with obese HFpEF, which