EXERCISE EFFECTS ON LEFT VENTRICULAR FUNCTION IN CONGESTIVE HEART FAILURE

将100例既往无运动训练史的NYHA II-IV级充血性心力衰竭患者根据性别和疾病病因分为不同的组，然后随机分配至4个月的运动训练组（ET，n=50）或无运动训练组（NT，n=50）。 将通过表面超声心动图筛选10名无已知冠状动脉疾病的久坐成人（SA），并进行运动训练作为对照组。 所有受试者将进行心肺运动耐量试验（ETT）前、中、后。 ET组和NT组将完成明尼苏达心力衰竭生活量表（HFQ）的术前和术后检查。 ET组和SA组将参加为期4个月的家庭运动训练，每周3-6天。 将向ET和SA受试者提供步行进展图表和运动指南;将返回每周日志，并每周通过电话联系受试者。 强度将以“中度至有点用力”的感觉用力水平规定，并将通过霍尔特监测（第3、7、11和15周）每季度进行评价。 锻炼的持续时间将因人而异。 在研究之前和之后，将测量所有受试者的脑钠肽（BNP）、肌钙蛋白I（TI）和血红蛋白（Hgb），以分别评价左心室壁应力、心肌坏死和携氧能力。 NT组将不给予运动处方，没有后续行动。

One hundred patients with NYHA class II-IV congestive heart failure who have no previous history of exercise training will be stratified into different groups depending upon gender and etiology of disease, and then randomized to 4 months of exercise training (ET, n=50) or no exercise training (NT, n=50). Ten sedentary adults (SA) without known coronary disease will be screened by surface echocardiography and perform exercise training as a comparison group. All subjects will perform pre, mid, and post cardiopulmonary exercise tolerance testing (ETT). ET and NT groups will complete pre and post Minnesota Living with Heart Failure Questionnaires (HFQ). The ET and SA groups will participate in 4 months of home-based exercise training 3-6 days per week. ET and SA subjects will be provided with a walking progression chart and exercise guidelines; weekly logs will be returned and subjects contacted via telephone on a weekly basis. Intensity will be prescribed at a perceived exertion level of "moderate to somewhat hard:, and will be evaluated quartely by holter monitoring (weeks 3, 7, 11, and 15). Duration of exercise will be individualized. Brain naturetic peptide (BNP), troponin I (TI), and hemoglobin (Hgb), will be measured before and after the study on all participants to evaluate left ventricular wall stress, myocardial necrosis, and oxygen carrying capacity, respectively. The NT group will not be given an exercise prescription no follow up.