EXERCISE EFFECTS ON LEFT VENTRICULAR FUNCTION IN CONGESTIVE HEART FAILURE

将100例NYHA II-IV级充血性心力衰竭患者按性别和病因分成不同的组，分别接受4个月运动训练(ET，n=50)和不运动训练(NT，n=50)。对10例无冠心病的久坐不动成人(SA)进行体表超声心动图筛查，并进行运动训练作为对照组。所有受试者将进行前、中、后心肺运动耐量试验(ETT)。ET组和NT组将在明尼苏达州心力衰竭生活问卷(HFQ)之前和之后完成。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受试者提供步行进度表和锻炼指南；每周将返回日志，并每周通过电话联系受试者。运动强度将被规定在“中等到有点剧烈”的感觉水平，并将通过Holter监测(第3、7、11和15周)每季度进行一次评估。运动持续时间将被个体化。所有参与者在研究前后将测量脑钠素(BNP)、肌钙蛋白I(TI)和血红蛋白(HGB)，以分别评估左室壁压力、心肌坏死和携氧能力。NT组将不接受运动处方，没有随访。

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.