Effect of endurance exercise training on endothelial function and arterial stiffness in older patients with heart failure and preserved ejection fraction: a randomized, controlled, single-blind trial.
Effect of endurance exercise training on endothelial function and arterial stiffness in older patients with heart failure and preserved ejection fraction: a randomized, controlled, single-blind trial.
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DOI：
10.1016/j.jacc.2013.04.033
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发表时间：
2013-08-13
影响因子：
24
通讯作者：
Haykowsky, Mark J.
中科院分区：
文献类型：
--
作者：
Kitzman, Dalane W.;Brubaker, Peter H.;Herrington, David M.;Morgan, Timothy M.;Stewart, Kathryn P.;Hundley, W. Gregory;Abdelhamed, Abdelhamed;Haykowsky, Mark J.
评估耐力运动训练 (ET) 对内皮依赖性血流介导的动脉扩张 (FMD) 和颈动脉僵硬度的影响，以及它们对射血分数保留的心力衰竭 (HFPEF) 老年患者训练相关的峰值运动耗氧量 (VO2) 增加的潜在贡献。老年 HFFEF 患者的峰值摄氧量严重降低，ET 后可改善这一情况，但这种改善的机制尚不清楚。 FMD 和动脉扩张性是运动反应的关键组成部分，并且会随着年龄的增长而降低。然而，尚不清楚这些是否会随着 ET 改善老年 HFPEF 或有助于训练相关的峰值摄氧量的改善。 63 名 HFPEF 患者（70±7 岁）被随机分配接受 16 周的 ET（步行、手臂和腿部测力，n=32）或注意力控制（CT；n=31）。在基线和随访时测量峰值摄氧量、袖带缺血引起的肱动脉 FMD、高分辨率超声显示的颈动脉扩张性、左心室功能和生活质量。 ET 增加了峰值 VO2（ET：15.8±3.3 对比 CT：13.8±3.1 ml/kg/min，p=0.0001）和 QOL。然而，肱动脉FMD（ET：3.8±3.0％ vs. CT：4.3±3.5％，p = 0.88）和颈动脉扩张性（ET：0.97±0.56 vs. CT：1.07±0.34 × 10-3mm × mmHg-1 p = 0.65）没有变化。 ET 未改变静息左心室收缩和舒张功能。在老年 HFPEF 患者中，16 周的 ET 改善了峰值摄氧量，但不改变内皮功能或动脉僵硬度。这表明其他机制，例如增强骨骼肌灌注和/或氧利用率，可能是 ET 介导的老年 HFPEF 患者峰值摄氧量增加的原因。
To evaluate the effects of endurance exercise training (ET) on endothelial dependent flow-mediated arterial dilation (FMD) and carotid artery stiffness and their potential contributions to the training-related increase in peak exercise oxygen consumption (VO2) in older patients with heart failure with preserved ejection fraction (HFPEF). Elderly HFFEF patients have severely reduced peak VO2 which improves with ET, however the mechanisms of this improvement are unclear. FMD and arterial distensibility are critical components of the exercise response and are reduced with aging. However, it's unknown whether these improve with ET in elderly HFPEF or contribute to the training-related improvement in peak VO2. 63 HFPEF patients (70±7 years) were randomized to 16 weeks of ET (walking, arm and leg ergometry, n=32) or attention control (CT; n=31). Peak VO2, brachial artery FMD in response to cuff ischemia, carotid artery distensibility by high-resolution ultrasound, LV function, and QOL were measured at baseline and follow-up. ET increased peak VO2 (ET: 15.8±3.3 vs. CT: 13.8±3.1 ml/kg/min, p=0.0001) and QOL. However, brachial artery FMD (ET: 3.8±3.0% vs. CT: 4.3±3.5%, p=0.88), and carotid arterial distensibility (ET: 0.97±0.56 vs. CT: 1.07±0.34 × 10-3mm × mmHg-1 p=0.65) were unchanged. Resting LV systolic and diastolic function were unchanged by ET. In elderly HFPEF patients, 16 weeks of ET improved peak VO2 without altering endothelial function or arterial stiffness. This suggests that other mechanisms, such as enhanced skeletal muscle perfusion and / or oxygen utilization, may be responsible for the ET-mediated increase in peak VO2 in older HFPEF patients.
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影响因子：
24
作者：
Haykowsky, Mark J.;Brubaker, Peter H.;Stewart, Kathryn P.;Morgan, Timothy M.;Eggebeen, Joel;Kitzman, Dalane W.
通讯作者：
Kitzman, Dalane W.
影响因子：
37.8
作者：
Kawaguchi, M;Hay, I;Kass, DA
通讯作者：
Kass, DA
影响因子：
18.2
作者：
Bhella, Paul S.;Prasad, Anand;Levine, Benjamin D.
通讯作者：
Levine, Benjamin D.
影响因子：
37.8
作者：
Herrington, DM;Brown, V;Raines, J
通讯作者：
Raines, J
影响因子：
37.8
作者：
Hambrecht, R;Fiehn, E;Schuler, G
通讯作者：
Schuler, G