Practical guidelines for exercise prescription in patients with chronic heart failure.
Practical guidelines for exercise prescription in patients with chronic heart failure.
复制标题
慢性心力衰竭患者运动处方实用指南。
DOI：
10.1007/s10741-023-10310-9
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发表时间：
2023
影响因子：
4.6
通讯作者：
Bonikowske,AmandaR
中科院分区：
文献类型：
--
作者：
Taylor,JennaL;Myers,Jonathan;Bonikowske,AmandaR
慢性心力衰竭（HF）是发病、死亡、残疾和医疗费用的主要原因。心力衰竭的一个标志性特征是严重的运动不耐受，这是多因素造成的，源于中枢和外周病理生理机制。运动训练被国际公认为心力衰竭患者的 1 类建议，无论射血分数是否降低或保持。最佳运动处方已被证明可以增强心力衰竭患者的运动能力、改善生活质量并减少住院率和死亡率。本文将回顾心力衰竭患者有氧训练、阻力训练和吸气肌训练的基本原理和当前建议。此外，该综述还提供了根据频率、强度、时间（持续时间）、类型、运动量和进展原则优化运动处方的实用指南。最后，该综述讨论了为心力衰竭患者制定运动处方时的常见临床考虑因素和策略，包括药物、植入设备、运动引起的缺血和/或虚弱的考虑因素。
Chronic heart failure (HF) is a major cause of morbidity, mortality, disability, and health care costs. A hallmark feature of HF is severe exercise intolerance, which is multifactorial and stems from central and peripheral pathophysiological mechanisms. Exercise training is internationally recognized as a Class 1 recommendation for patients with HF, regardless of whether ejection fraction is reduced or preserved. Optimal exercise prescription has been shown to enhance exercise capacity, improve quality of life, and reduce hospitalizations and mortality in patients with HF. This article will review the rationale and current recommendations for aerobic training, resistance training, and inspiratory muscle training in patients with HF. Furthermore, the review provides practical guidelines for optimizing exercise prescription according to the principles of frequency, intensity, time (duration), type, volume, and progression. Finally, the review addresses common clinical considerations and strategies when prescribing exercise in patients with HF, including considerations for medications, implantable devices, exercise-induced ischemia, and/or frailty.