EXERCISE AND DIET IN CONGESTIVE HEART FAILURE

由于冠状动脉疾病和高血压的高患病率 充血性心力衰竭的发病率在20 - 30岁之间增加了50倍， 年龄在40至60岁之间，目前是一种常见的主要诊断 美国老年人。 左心室症状减轻 功能导致运动能力和功能的显著下降 独立 与心力衰竭相关的外周适应不良 导致骨骼肌、肢体血流和 动脉顺应性 最近的小型试验表明， 运动训练可提高青年心脏的运动耐力 失败的患者通过外周适应。 不幸的是，这些研究 没有具体说明有氧运动的可行性和安全性， 老年心力衰竭患者的运动训练 我们建议 定期的运动康复计划将是一个安全有效的 临床策略，以改善与 老年人心力衰竭 本研究将入组心力衰竭患者 60岁以上NYHA II级和III级充血性心力衰竭患者 失败 60名心力衰竭患者将被随机分配到一项运动 干预组和常规护理组。“预计演习 将导致峰值耗氧量增加15%， 锻炼能力和增强功能独立性。 最大和 亚极量运动持续时间，峰值耗氧量，肌肉结构 肢体血流神经激素激活和身体 将在培训之前和之后进行评估。 本临床 试验将证明老年心力衰竭患者可以安全地 功能性指标有实质性改善的运动 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.