EXERCISE EFFECTS ON LEFT VENTRICULAR FUNCTION IN CONGESTIVE HEART FAILURE

100例无运动训练史的NYHA II-IV级充血性心力衰竭患者将根据性别和疾病病因分层，然后随机分为4个月运动训练组（ET, n=50）和无运动训练组（NT, n=50）。10名无冠状动脉疾病的久坐成年人（SA）将通过表面超声心动图进行筛查，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测试（ETT）前、中、后。ET组和NT组将完成明尼苏达州心力衰竭患者生活问卷调查（HFQ）前后。ET组和SA组将参加为期4个月的居家运动训练，每周3-6天。ET和SA受试者将获得步行进度表和运动指南；每周的日志将被返还，并每周通过电话联系受试者。强度将被规定为“中等到有点硬”的运动水平，并将通过动态心电图监测每季度评估一次（第3,7,11和15周）。运动时间将因人而异。所有受试者在研究前后分别测定脑天然肽（BNP）、肌钙蛋白I （TI）和血红蛋白（Hgb），评估左室壁应激、心肌坏死和携氧能力。NT组不会得到运动处方，也没有随访。

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.