Age-related effects of exercise training on diastolic function in heart failure with reduced ejection fraction: The Leipzig Exercise Intervention in Chronic Heart Failure and Aging (LEICA) Diastolic Dysfunction Study

作者：Sandri Marcus; Kozarez Irina; Adams Volker; Mangner Norman; Hoellriegel Robert; Erbs Sandra; Linke Axel; Moebius Winkler Sven; Thiery Joachim; Kratzsch Juergen; Teupser Daniel; Mende Meinhard; Hambrecht Rainer; Schuler Gerhard; Gielen Stephan^*

来源：European Heart Journal, 2012, 33(14): 1758-1768.

DOI：10.1093/eurheartj/ehr469

• Ageing
• Diastolic function
• Exercise
• Aerobic endurance
• Heart failure
• Systolic

Diastolic dysDD) was identified as a predictor of adverse prognosis in heart failure with reduced ejection fraction (HFREF). It is, however, unknown if DD is improved by exercise training, which is known to induce reverse remodelling, and if the training effect is attenuated in elderly HFREF patients. We therefore assessed DD in a cohort of referent controls (RCs) and HFREF patients and studied the response of DD to endurance exercise in two age groups (55 years and epsilon 65 years). %26lt;br%26gt;Sixty RC (30 55 years, mean age 50 5 years; 30 epsilon 65 years, 72 4 years) and 60 HFREF patients (30 55 years, 46 5 years; 30 epsilon 65 years, 72 5 years, EF 28 5) were randomized to 4 weeks of supervised endurance training or to a control group. Exercise training was effective in reducing LV isovolumetric relaxation time by 29 in young and by 26 in old HFREF patients (P 0.05 for both). As assessed by tissue Doppler, septal E increased by 37 in young and by 39 among old HFREF patients (P 0.005 for both) resulting in a significant decrease in the E/E ratio from 13 1 to 10 1 in young and 14 1 to 11 1 in old HFREF patients (P 0.05 for both). Serum levels of N-terminal pro brain natriuretic peptide were significantly reduced after endurance training in HFREF patients of all ages. %26lt;br%26gt;In HFREF, diastolic function is significantly impaired in all age groups. Endurance training is highly effective in improving left ventricular diastolic function in HFREF patients regardless of age. %26lt;br%26gt;This study is registered at ClinicalTrials.gov (number: NCT00176319).

• 出版日期2012-7