Efficacy and mechanisms of exercise training in diastolic heart failure

心力衰竭是一种现代流行病，由于死亡率高、频繁住院和功能能力受损，造成了重大的公共卫生负担。虽然典型的心力衰竭患者表现为收缩功能降低，但许多患者具有典型的心力衰竭症状，但收缩正常。这些患者的问题似乎与心脏的血液充盈能力有关，这种实体被称为舒张性心力衰竭（DHF）。这种综合征最常见于缺血性或高血压性心脏病，最常见于老年人。DHF的最佳管理尚未明确，尽管目前正在进行一些药物试验。许多研究表明，运动训练可使典型心力衰竭患者的功能能力提高15-20%。然而，迄今为止，培训尚未在DHF中试行。在这项多中心、多学科研究中，我们将研究训练组和对照组，以确定运动能力和DHF症状是否对运动训练有反应。这项工作将教会我们最佳的运动处方，在训练的持续时间和性质，以及运动训练的安全性和有效性方面。通过使用一些敏感的心脏和血管功能的测量（在这方面，我们的小组有特殊的专业知识），我们将确定运动训练是否通过改善血管功能和心肌特性发挥其作用。如果成功，本研究的临床意义是：1。通过运动训练改善DHF 2患者的功能和症状. DHF 3将确定有氧和力量训练的优点。血管功能异常将被确定为DHF的主要和可逆贡献者

Heart failure is modern epidemic which presents a significant public health burden, due to a high mortality, frequent hospital admissions and impaired functional capacity. Although the typical heart failure patient presents with a reduced contractile function, many patients have typical heart failure symptoms but with normal contraction. The problem in these patients seems to relate to the heart's ability to fill with blood, and this entity is known as diastolic heart failure (DHF). This syndrome is most frequently due to ischemic or hypertensive heart disease, and most commonly occurs in the elderly. The optimal management of DHF is not well defined, although some drug trials are currently in progress. A number of studies have shown exercise training to improve functional capacity by 15-20% in typical heart failure. However, training has not so far been trialled in DHF. In this multicenter, multi-disciplinary study, we will study a training and control group to determine whether exercise capacity and DHF symptoms are responsive to exercise training. This work will teach us about the optimum exercise prescription, in terms of the duration and nature of training, as well as the safety and effectiveness of exercise training. By using a number of sensitive measurements of heart and vessel function (in which our group has special expertise), we will identify whether exercise training exerts its effect through improvement in vascular function and myocardial properties. If successful, the clinical implications of this study are that; 1. Exercise training will be adopted to improve functional capacity and symptoms of DHF 2. The merits of aerobic and strength training will be identified in DHF 3. Abnormal blood vessel function will be identified as a major and reversible contributor to DHF