EXERCISE AND DIET IN CONGESTIVE HEART FAILURE

由于冠状动脉疾病和高血压的高发病率 充血性心力衰竭的发生率在两年间增加了50倍 年龄在40到60岁之间，目前是一种常见的主要诊断 在老年美国人中。有症状的左室缩窄 机能导致运动能力和机能明显下降 独立。与心力衰竭相关的外周适应不良 导致骨骼肌、四肢血流量和 动脉顺应性。最近的小规模试验表明，有规律的有氧运动 运动训练可提高年轻心脏的运动耐量 通过外周适应而失败的患者。不幸的是，这些研究 还没有具体讨论有氧运动的可行性和安全性 运动训练在老年心力衰竭患者中的应用我们建议一项 定期运动康复计划将是一项安全有效的计划 改善与以下疾病相关的功能限制的临床策略 老年人群中的心力衰竭。这项研究将纳入心力衰竭 60岁以上患有NYHA II级和III级充血性疾病的患者 失败了。60名心力衰竭患者将被随机分配到锻炼组 干预组和“常规护理”。预计这次演习 将导致峰值耗氧量增加15%，并改善 运动能力和功能独立性增强。最大和 次极量运动持续时间、最大耗氧量、肌肉结构 和功能、肢体血流、神经激素的激活和身体 作文将在培训前和培训后进行评估。这个诊所 试验将证明老年心力衰竭患者可以安全地 运动功能指数有显著改善 独立。

Due to the high prevalence of coronary artery disease and hypertension the incidence of congestive heart failure increases 50 fold between the ages of 40 to 60 years and is currently a frequent and primary diagnosis in elderly Americans. Symptomatic reductions in left ventricular function result in marked declines in exercise capacity and functional independence. The peripheral maladaptation associated with heart failure result in detrimental changes in skeletal muscle, limb blood flow and arterial compliance. Recent small trials have shown that regular aerobic exercise training can improve the exercise tolerance of younger heart failure patients by peripheral adaptations. Unfortunately, these studies have not specifically addressed the feasibility and safety of aerobic exercise training in elderly heart failure patients. We propose that a regular exercise rehabilitation program will be a safe and effective clinical strategy to improve the functional limitations associated with heart failure in older populations. This study will enroll heart failure patients over the age of 60 years with NYHA class II and III congestive failure. Sixty heart failure patients will be randomized to an exercise intervention group and to "usual care." It is anticipated that exercise will result in a 15% increase in peak oxygen consumption and improved exercise capacity and increased functional independence. Maximal and submaximal exercise duration, peak oxygen consumption, muscle structure and function, limb blood flow neurohormonal activation and body composition will be assessed before and after training. This clinical trial will demonstrate that older heart failure patients can safely exercise with substantial improvement in the indices of functional independence.