STUDY OF THE EFFECTS CALORIC RESTRICTION AND EXERCISE TRAINING IN PATIENTS

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 射血分数正常的心力衰竭（HFNEF，以前称为舒张性心力衰竭）在>65岁的人群中占心力衰竭病例的主要部分，并且已被认为是真正的老年综合征。运动不耐受是HFNEF的主要慢性症状，也是这些患者生活质量严重降低的主要决定因素;然而，对其病理生理学和治疗知之甚少。所提出的研究的目的是进行随机、对照、单盲、2x2设计试验，以在100名HFNEF和体重指数> 30的患者中检查通过低热量饮食、有氧运动训练、低热量饮食和运动训练组合以及注意力控制的体重减轻的效果，以检验以下假设：1.减肥和运动训练都将改善HFNEF老年肥胖患者的运动不耐受和生活质量。2.减肥和运动训练的结合将对HFNEF的身体和大腿肌肉组成产生互补作用，并增加运动不耐受的改善。3.运动不耐受的改善将与瘦体重的改善、不利的大腿肌肉重塑的逆转和大腿肌肉毛细血管作用的增加相关。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Heart failure with a normal ejection fraction (HFNEF, previously termed diastolic heart failure), accounts for the majoirty of heart failure cases in the population >65 years old and has been recognozed as a true geriatric syndrome. Exercise intolerance is the primary chronic symptom of HFNEF and a major determinant of these patients' severly reduced quality of life; however little is known regarding its pathophysiology and treatment. The aims of the proposed study are to conduct a randomized, controlled, single-blinded, 2x2 design trial to examine the effects of weight loss via hypocaloric diet, aerobic exercise training, combined hypocaloric diet and exercise training, and attention control in 100 patients with HFNEF and body mass index > 30 in order to test the following hypotheses: 1. Both weight loss and exercise training will improve exercise intolerance and quality of life in older obese patients with HFNEF. 2. The combination of weight loss and exercise training will produce complementary effects on body and thigh muscle composition and additive improvements in exercise intolerance in HFNEF. 3. Improvements in exercise intolerance will correlate with improvments in lean body mass, reversal of adverse thigh muscle remodelling, and increased thigh muscle capillarity.