Therapeutic effect of resistance exercise in elderly patients with chronic heart failure combined with sarcopenia
10.3760/cma.j.issn.0254-9026.2024.09.005
- VernacularTitle:老年慢性心力衰竭合并肌少症患者抗阻运动的疗效观察
- Author:
Zengshuai WANG
1
;
Yanan LIU
;
Yulan LI
;
Caixia FENG
Author Information
1. 内蒙古科技大学包头医学院第二附属医院，包头 014030
- Keywords:
Heart failure;
Exercise therapy;
Sarcopenia;
Resistance training
- From:
Chinese Journal of Geriatrics
2024;43(9):1107-1113
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the efficacy and safety of low-and medium-intensity resistance exercise in patients with chronic heart failure(CHF)combined with sarcopenia.Methods:In the randomized controlled study, 100 elderly patients with CHF combined with sarcopenia who were hospitalized in the Department of Cardiology of the Second Affiliated Hospital of Baotou Medical College from October 2020 to August 2022 were selected and divided into the control group and the intervention group according to the randomized numerical scale method.In the control group, angiotensin-converting enzyme inhibitors/angiotensin receptor inhibitors, β receptor antagonists, diuretics and other standard heart failure medications were routinely given, as well as nutritional support, health education and guidance; in the intervention group, low-intensity resistance exercise was given in addition to the treatment of the control group, and the two groups were evaluated for the NYHA cardiac function classification, grip strength, 5 times sitting time, 6-meter walking time, serum B-type natriuretic peptide level before and after 12 weeks of treatment; limb skeletal muscle mass index(ASMI), visceral fat area, extracellular water ratio were measured by body composition analyzer; right ventricular internal diameter, left atrial internal diameter, left ventricular end-diastolic internal diameter, left ventricular ejection fraction(LVEF) were measured by echocardiography.Changes in each index before and after treatment were compared between the 2 groups.Serious adverse cardiovascular events related to training were followed up by outpatient clinic visits or telephone at 4-week interval over 12 weeks.Results:30 cases were dislodged because they could not adhere to the exercise or could not follow up on time, and finally 70 patients were included, 27 in the control group and 43 in the intervention group.Compared with pre-treatment, grip strength[(17.73±4.54)kg vs.(17.00±4.32)kg, t=8.969], limb skeletal muscle mass[(17.57±3.41)kg vs.(17.24±3.34)kg, t=7.170], and ASMI[(6.02±0.72)kg/m 2vs.(5.85±0.67)kg/m 2, t=6.866]were elevated in the intervention group after 12 weeks(all P<0.05); 5 times sitting up time[(16.17±3.25)s vs.(14.54±3.21)s, t=12.808, ]and 6-meter walking time[(12.30±3.24)s vs.(10.76±3.14)s, t=9.391]shortened(all P<0.05).Compared with pre-treatment, the intervention group showed reduced left ventricular end-diastolic internal diameter[(59.62±9.07)mm vs.(58.48±9.71)mm, t=4.552], increased LVEF[(34.69±7.93)% vs.(35.88±7.92)%, t=4.752], and increased extracellular water ratio[(39.27±7.74)% vs.(38.92±7.41)%, t=6.058]after 12 weeks(all P<0.05).At 12 weeks of follow-up, no training-related serious adverse events occurred in the intervention group.The difference in the incidence of serious adverse cardiovascular events between the two groups(3.70% vs.2.33%, P>0.05)was not statistically significant. Conclusions:Treatment combined with low-and moderate-intensity resistance exercise improves muscle mass, muscle strength, physical function, and cardiac function in elderly patients with CHF combined with sarcopenia without increasing the incidence of adverse events.
