Regular physical exercise corrects endothelial dysfunction and improves exercise capacity in patients with chronic heart failure
Regular physical exercise corrects endothelial dysfunction and improves exercise capacity in patients with chronic heart failure
复制标题
DOI：
10.1161/01.cir.98.24.2709
复制
发表时间：
1998-12-15
期刊：
影响因子：
37.8
通讯作者：
Schuler, G
中科院分区：
文献类型：
--
作者：
Hambrecht, R;Fiehn, E;Schuler, G
本研究的目的是确定全身运动训练对慢性心力衰竭（CHF）患者下肢内皮介导的小动脉血管舒张的影响及其与运动能力的关系。内皮功能障碍是CHF的关键特征，导致外周血管收缩增加和运动能力受损。局部握力锻炼先前已被证明可以增强CHF中导管和阻力血管的内皮依赖性血管舒张。方法和结果20例患者前瞻性随机分为训练组（n = 10，左心室射血分数[LVEF] 24+/-4%）或对照组（n=10，LVEF 23+/-3%）。在基线和6个月后，使用多普勒导丝测量左股动脉的峰值流速;通过定量血管造影确定血管直径。外周血流量由平均峰值流速（APV）和动脉横截面积计算。运动训练后，硝酸甘油诱导的内皮非依赖性血管舒张保持不变（271%对281%，P=NS）。90 μ g/min乙酰胆碱可显著改善外周血流量，增加203%（从152+/-79至461+/-104 mL/min，P
Background-The purpose of this study was to determine the effects of systemic exercise training on endothelium-mediated arteriolar vasodilation of the lower limb and its relation to exercise capacity in chronic heart failure (CHF). Endothelial dysfunction is a key feature of CHF, contributing to increased peripheral vasoconstriction and impaired exercise capacity. Local handgrip exercise has previously been shown to enhance endothelium-dependent vasodilation in conduit and resistance vessels in CHF.Methods and Results-Twenty patients were prospectively randomized to a training group (n = 10, left ventricular ejection fraction [LVEF] 24+/-4%) or a control group (n=10, LVEF 23+/-3%). At baseline and after 6 months, peak flow velocity was measured in the left femoral artery using a Doppler wire; vessel diameter was determined by quantitative angiography. Peripheral blood flow was calculated from average peak velocity (APV) and arterial cross-sectional area. After exercise training, nitroglycerin-induced endothelium-independent vasodilation remained unaltered (271% versus 281%, P=NS). Peripheral blood flow improved significantly in response to 90 mu g/min acetylcholine by 203% (from 152+/-79 to 461+/-104 mL/min, P