Training and Diastolic Function in Postmenopausal Women

描述（由申请人提供）：充血性心力衰竭（CHF）已成为美国住院的头号原因。妇女因这种疾病住院的人数多于男子（1998年，妇女为540 000人，男子为438 000人）。舒张功能障碍越来越被认为是CHF病因学的重要因素。在所有受影响的人群中，70%的舒张性心力衰竭患者为女性，其中大多数为老年人。目前没有有效的药物治疗舒张功能。由于横断面研究和有限的训练试验（仅限男性）支持运动可改善舒张功能的假设，因此需要进行更适当对照和充分把握度的研究，检查运动训练对舒张功能的影响，特别是在CHF高危人群中，如久坐、绝经后血压升高的女性。拟议的研究是NHLBI女性运动剂量反应（DREW）研究的前瞻性辅助研究。DREW始于2001年1月。在DREW中，450名超重、久坐、绝经后妇女将被随机分配到非运动对照组或3个运动组中的1个，运动量分别为公众健康推荐的每周体育活动（运动）的50%、100%和150%。锻炼妇女在我们中心进行6个月的监督锻炼。DREW研究将评估运动训练对多种心脏危险因素变化的剂量反应。我们建议在本研究人群的一个子集中测量舒张功能，以检查体力活动（和健身）变化与舒张功能之间的剂量反应关系。我们预计在总共215名女性中进行基线和随访舒张功能测量，其中每个运动组约包括50名女性。这项研究是一个独特的，及时的，有效的机会，快速探索舒张功能和体力活动之间的关系，绝经后妇女。

DESCRIPTION (provided by applicant): Congestive heart failure (CHF) has become the number one reason for hospitalization in the United States. Women are more commonly hospitalized than men for this condition (in 1998, 540,000 women compared with 438,000 men). Diastolic dysfunction is becoming increasingly recognized as a significant factor in the etiology of CHF. Of the total affected population, 70% of patients with diastolic heart failure are female, with a majority being elderly. There is currently no effective pharmacological therapy for the treatment of diastolic function. With the cross-sectional studies and limited training trials (men only) supporting the hypothesis that exercise may improve diastolic function, there is a need for more properly controlled and adequately powered studies examining the effect of exercise training on diastolic function, particularly in populations at high risk for CHF such as sedentary, postmenopausal women with elevated blood pressure. The proposed study is a prospective ancillary study to the NHLBI Dose-Response to Exercise in Women (DREW) study. DREW started in January 2001. In DREW, 450 overweight, sedentary, postmenopausal women will be randomly assigned either to a non-exercise control group or to 1 of 3 exercise groups at 50, 100, and 150%, respectively, of the consensus public health recommendation for weekly physical activity (exercise). Exercising women perform supervised exercise for 6 months at our center. The DREW study will evaluate the dose-response of exercise training in regard to changes in multiple cardiac risk factors. We propose to measure diastolic function in a sub-set of this study population to examine the dose-response relation between changes in physical activity (and fitness) and diastolic function. We anticipate performing baseline and follow-up measurement of diastolic function in a total of 215 women, which will include approximately 50 women per exercise group. This study represents a unique, timely, and efficient opportunity to quickly explore the relation between diastolic function and physical activity in postmenopausal women.