标题:耐力运动训练对射血分数保留型心衰患者峰值氧耗量和舒张功能的影响
作者:邱志超,陈珏通,张建勇,文彩虹,邢哲,刘桂斌,曾凡超,钟志雄,袁玉琴 韶关市第一人民医院心血管内科,广东 韶关 512000
卷次:
2021年32卷14期
【摘要】 目的 探讨耐力运动训练对射血分数保留型心衰(HFpEF)患者峰值氧耗量(Peak VO2)和舒张功能的影响。方法 选择2019年1月至2020年12月韶关市第一人民医院心血管内科诊治的70例HFpEF患者为研究对象,根据随机数表法将患者分为耐力运动训练组(试验组,n=35)和常规治疗组(对照组,n=35),干预时间均为3个月,比较两组患者干预前后心肺运动试验中的Peak VO2、无氧阈值(VO2AT)、分钟通气量与二氧化碳排出量斜率(VE/VCO2slop)、6 min步行距离以及超声心动图指标[包括二尖瓣充盈早期峰值速度与二尖瓣环舒张早期速度比值(E/e')、二尖瓣环舒张早期速度(e')和左心房容量指数(LAVI)]。结果 干预后,试验组患者的Peak VO2、VO2AT和6 min步行距离分别为(18.6±5.5) mL/(min·kg)、(12.8±3.5) mL/(min·kg)、(567.6±81.7) m,明显高于干预前的(16.4±4.8) mL/(min·kg)、(10.3±3.0) mL/(min·kg)、(541.6±83.2) m,VE/VCO2 slop为30.0±4.6,明显低于干预前的34.1±5.4,而E/e'比值和LAVI分别为10.5±2.5、(24.5±6.3) mL/m2,明显少于干预前的12.8±3.2、(27.8±7.3) mL/m2,e'为(6.3±1.3) cm/s,明显高于干预前的(5.4±1.2) cm/s,且上述指标干预后观察组均明显优于对照组,差异均有统计学意义(P<0.05);但对照组患者的上述各项指标在随访后与干预前比较差异均无统计学意义(P>0.05)。结论 耐力运动训练可增加HFpEF患者Peak VO2,提高运动耐量并改善左室舒张功能,安全性和耐受性好。
【关键词】 射血分数;心力衰竭;耐力运动训练;峰值氧耗量;舒张功能
【中图分类号】 R541.6 【文献标识码】 A 【文章编号】 1003—6350(2021)14—1786—03
Effect of endurance excise training on peak oxygen consumption and diastolic function in patients with heartfailure and preserved ejection fraction.
QIU Zhi-chao, CHEN Jue-tong, ZHANG Jian-yong, WEN Cai-hong, XINGZhe, LIU Gui-bin, ZENG Fan-chao, ZHONG Zhi-xiong, YUAN Yu-qin. Department of Cardiovascular Medicine, ShaoguanFirst People's Hospital, Shaoguan 512000, Guangdong
【Abstract】 Objective To investigate the effect of endurance excise training on peak oxygen consumption(Peak VO2) and diastolic function in patients with heart failure with preserved ejection fraction (HFpEF). Methods Atotal of 70 patients with compensatory HFpEF from January 2019 to December 2020 treated in Department of Cardiovascu-lar Medicine, Shaoguan First People's Hospital were included in this study, and then they were randomly divided into a3-month endurance exercise training group (experimental group, n=35) and a conventional treatment group (control group,n=35) according to random number table method. The intervention time was 3 months, and the peak VO2,VO2AT, VE/VCO2 slop of the two groups before and after the intervention were compared. The walking distance of 6 minutes, E/e', e'and LAVI were compared. Results After intervention, peak VO2, VO2AT, and 6-minute walk test were in the experimen-tal group was (18.6±5.5) mL/(min·kg), (12.8±3.5) mL/(min·kg), (567±81) m, as compared with (16.4±4.8) mL/(min·kg),(10.3±3.0) mL/(min·kg), (541±83) m before intervention; Ve/VCO2 slope was 30.0±4.6, which was lower than the base-line value 34.1±5.4; the E/e 'ratio and LAVI were 10.5±2.5 and (24.5±6.3) mL/m2, which were lower than 12.8±3.2 and(27.8±7.3) mL/m2 before intervention; e' was (6.3±1.3) cm/s, which was higher than (5.4±1.2) cm/s before intervention;the differences were all statistically significant (P<0.05). Besides, the above indexes in the observation group were signif-icantly better than those in the control group, and the differences were statistically significant (P<0.05). However, in thecontrol group, all the indicators were not statistically different as compared with those before intervention (P>0.05). Allpatients completed the training tasks safely. Conclusion Endurance exercise training can increase peak VO2, improveexercise endurance and improve left ventricular diastolic function in patients with HFpEF. It has good safety and toler-ance, and it is worthy of clinical promotion.
【Key words】 Ejection fraction; Heart failure; Endurance excise training; Peak oxygen consumption; Diastolicfunction
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