Tập thể dục như một liệu pháp bổ trợ cho bệnh nhân suy tim sung huyết: Lựa chọn bệnh nhân, giao thức tập luyện, kết quả và hướng đi trong tương lai

Current Cardiology Reports - Tập 1 - Trang 38-46 - 1999
R. Hambrecht1, S. Gielen2, G. Schuler2
1Department of Internal Medicine/Cardiology, University of Leipzig — Heart Center, Leipzig, Germany
2Department of Internal Medicine/Cardiology, University of Leipzig–Heart Center, Leipzig, Germany

Tóm tắt

Sự không dung nạp với tập thể dục ở những bệnh nhân bị suy tim mạn tính (CHF) không cho thấy mối tương quan với mức độ rối loạn chức năng tâm thất trái. Phát hiện bất ngờ này đã hướng sự chú ý đến những thay đổi ngoại biên ở CHF: sự giảm thiểu giãn mạch phụ thuộc nội mô và chuyển hóa cơ vân bị thay đổi. Huấn luyện thể chất đã phát triển thành một phương pháp điều trị quan trọng để ảnh hưởng đến những nguyên nhân không phải tim mạch của sự không dung nạp với tập thể dục. Nó đã được chứng minh là làm tăng khả năng oxy hóa của cơ vân đang hoạt động, làm giảm hoạt động của phản xạ cơ, khắc phục rối loạn chức năng nội mô và cải thiện thông khí. Tất cả các thích nghi do tập thể dục gây ra đều hội tụ để tăng lượng oxy tối đa hấp thu lên tới 2 mL/kg.phút-1. Sự không chắc chắn vẫn tồn tại về việc lựa chọn bệnh nhân tối ưu, giao thức tập luyện và tác động lâu dài lên chức năng tim. Đối với những bệnh nhân trải qua suy tim ổn định trong khi đang sử dụng thuốc tim mạch tối ưu, sự kết hợp giữa đào tạo chịu đựng aerobic tại bệnh viện và tại nhà, kết hợp với đào tạo sức mạnh cơ tại chỗ, dường như là phương pháp hứa hẹn nhất. Mặc dù đào tạo thể dục không cung cấp điều trị nguyên nhân cho CHF, nhưng nó có tiềm năng lớn như một liệu pháp bổ sung nhằm cải thiện khả năng dung nạp tập thể dục và mở rộng giới hạn thể chất của bệnh nhân CHF.

Từ khóa

#suy tim mạn tính #tập thể dục #liệu pháp bổ trợ #huấn luyện thể chất #dung nạp tập thể dục

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