High-Intensity Interval Training Is Associated With Improved 10-Year Survival by Mediating Left Ventricular Remodeling in Patients With Heart Failure With Reduced and Mid-Range Ejection Fraction

被引：5

作者：

Hsu, Chih-Chin ^{[3
,4
]}

Fu, Tieh-Cheng ^{[3
,5
]}

Wang, Chao-Hung ^{[4
,5
]}

Huang, Ting-Shuo ^{[6
,7
,8
]}

Cherng, Wen-Jin ^{[2
,4
,9
]}

Wang, Jong-Shyan ^{[1
,3
,10
,11
]}

机构：

[1] Chang Gung Univ, Dept Phys Therapy, 259 Wen Hwa 1st Rd,Gueishan, Taoyuan 333, Taiwan

[2] Chang Gung Mem Hosp, Dept Internal Med, Div Cardiol, Linkou Branch, 5 Fusing St,Gueishan, Taoyuan 333, Taiwan

[3] Keelung Chang Gung Mem Hosp, Dept Phys Med & Rehabil, Keelung, Taiwan

[4] Chang Gung Univ, Coll Med, Sch Med, Taoyuan, Taiwan

[5] Chang Gung Mem Hosp, Heart Failure Ctr, Dept Internal Med, Div Cardiol, Keelung, Taiwan

[6] Keelung Chang Gung Mem Hosp, Dept Surg, Div Gen Surg, Keelung, Taiwan

[7] Chang Gung Univ, Coll Med, Dept Chinese Med, Taoyuan, Taiwan

[8] Keelung Chang Gung Mem Hosp, Community Med Res Ctr, Keelung, Taiwan

[9] Chang Gung Mem Hosp, Dept Internal Med, Div Cardiol, Linkou Branch, Taoyuan, Taiwan

[10] Chang Gung Univ, Hlth Aging Res Ctr, Taoyuan, Taiwan

[11] Chang Gung Univ Sci & Technol, Coll Human Ecol, Res Ctr Chinese Herbal Med, Taoyuan, Taiwan

来源：

JOURNAL OF THE AMERICAN HEART ASSOCIATION | 2024年 / 13卷 / 03期

关键词：

aerobic exercise; heart failure; left ventricular remodeling; mediation analysis; survival; PROGNOSTIC VALUE; MORTALITY; EPIDEMIOLOGY;

D O I：

10.1161/JAHA.123.031162

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: This study aimed to assess the left ventricular (LV) remodeling response and long-term survival after high-intensity interval training (HIIT) in patients with various heart failure (HF) phenotypes during a 10-year longitudinal follow-up. Methods and Results: Among 214 patients with HF receiving guideline-directed medical therapy, those who underwent an additional 36 sessions of aerobic exercise at alternating intensities of 80% and 40% peak oxygen consumption (VO2peak) were considered HIIT participants (n=96). Patients who did not undergo HIIT were considered participants receiving guideline-directed medical therapy (n=118). Participants with LV ejection fraction (EF) <40%, >= 40% and <50%, and >= 50% were considered to have HF with reduced EF, HF with mid-range EF, and HF with preserved EF, respectively. VO2peak, serial LV geometry, and time to death were recorded. In all included participants, 10-year survival was better (P=0.015) for participants who underwent HIIT (80.3%) than for participants receiving guideline-directed medical therapy (68.6%). An increased VO2peak, decreased minute ventilation carbon dioxide production slope, and reduced LV end-diastolic diameter were protective factors against all-cause mortality. Regarding 138 patients with HF with reduced EF (P=0.044) and 36 patients with HF with mid-range EF (P=0.036), 10-year survival was better for participants who underwent HIIT than for participants on guideline-directed medical therapy. Causal mediation analysis showed a significant mediation path for LV end-diastolic diameter on the association between HIIT and 10-year mortality in all included patients with HF (P<0.001) and those with LV ejection fraction <50% (P=0.006). HIIT also had a significant direct association with 10-year mortality in patients with HF with LV ejection fraction <50% (P=0.027) but not in those with LV ejection fraction >= 50% (n=40). Conclusions: Reversal of LV remodeling after HIIT could be a significant mediating factor for 10-year survival in patients with HF with reduced EF and those with HF with mid-range EF.

引用

页数：14

共 47 条

[1] Imaging, Biomarker, and Clinical Predictors of Cardiac Remodeling in Heart Failure With Reduced Ejection Fraction [J].