Myocardial work and left ventricular mechanical adaptations following isometric exercise training in hypertensive patients
Myocardial work and left ventricular mechanical adaptations following isometric exercise training in hypertensive patients
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DOI：
10.1007/s00421-021-04882-3
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发表时间：
2022-01-30
影响因子：
3
通讯作者：
Sharma, Rajan
中科院分区：
文献类型：
--
作者：
O'Driscoll, Jamie M.;Edwards, Jamie J.;Sharma, Rajan
目的高血压是心血管疾病的主要危险因素。等长运动训练(IET)可降低静息和动态血压；然而，很少有研究研究IET对心肌适应性的影响。方法采用交叉研究设计，将24例未服药的高血压患者随机分为4周的IET治疗和3周的清洗期。斑点跟踪超声心动图用于测量左心室(LV)力学，并由以臂部收缩压为指标的整体纵向应变(GLS)构建的无创性LV压力-应变环计算整体心肌做功指数。结果IET显著提高了GLS(-2.3+/-2%，p<；0.001)和整体工作效率(2.8+/-2%，p<；0.001)，显著减少了整体工作浪费(-42.5+/-30 mm Hg%，p<；0.001)，但在控制期内无明显变化。结论：这是第一个证明IET显著改善相关患者群体心脏健康的证据。我们的发现对高血压患者具有重要的临床意义，并支持IET在高血压治疗中作为一种安全可行的治疗性和预防性干预的作用。
Purpose Hypertension is a major risk factor for cardiovascular disease. Isometric exercise training (IET) reduces resting and ambulatory blood pressure; however, few studies have investigated the myocardial adaptations following IET. Methods We randomly assigned 24 unmedicated hypertensive patients in a cross-over study design to 4-weeks of IET and control period, separated by a 3-week washout period. Speckle tracking echocardiography was used to measure left ventricular (LV) mechanics, and global myocardial work indices were derived from non-invasive LV pressure-strain loops constructed from global longitudinal strain (GLS) indexed to brachial systolic blood pressure. Results IET significantly improved GLS (- 2.3 +/- 2%, p < 0.001) and global work efficiency (2.8 +/- 2%, p < 0.001), and significantly reduced global wasted work (- 42.5 +/- 30 mmHg%, p < 0.001) with no significant change during the control period. Conclusions This is the first evidence to demonstrate that IET significantly improved cardiac health in a relevant patient population. Our findings have important clinical implications for patients with high blood pressure and support the role of IET as a safe and viable therapeutic and preventative intervention in the treatment of hypertension.