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Сравнительный анализ аэробных кардиореспираторных тренировок высокой и умеренной интенсивности у больных кардиохирургического профиля - Научно-практический журнал Cardioсоматика Том 12, №4 (2021)
Сравнительный анализ аэробных кардиореспираторных тренировок высокой и умеренной интенсивности у больных кардиохирургического профиля
Какучая Т.Т., Джитава Т.Г., Пачуашвили Н.В., Куулар А.М., Домрачева И.И., Закарая Н.Э. Сравнительный анализ аэробных кардиореспираторных тренировок высокой и умеренной интенсивности у больных кардиохирургического профиля. CardioСоматика. 2021;12(4):190–199. DOI: 10.17816/22217185.2021.4.201261
DOI: 10.17816/22217185.2021.4.201261
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DOI: 10.17816/22217185.2021.4.201261
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Аннотация
Цель. Провести сравнительный анализ эффективности аэробных кардиореспираторных интервальных тренировок высокой интенсивности и постоянных тренировок умеренной интенсивности в кардиореабилитации взрослых больных после операций на открытом сердце.
Материал и методы. В исследование вошли 137 пациентов после аортокоронарного шунтирования (АКШ). Проводилось сравнение групп пациентов по программам реабилитационных мероприятий: одной группе проводились постоянные аэробные тренировки умеренной и средней интенсивности, другой – аэробные высокоинтенсивные интервальные физические тренировки. Подавляющее большинство пациентов после АКШ (90,4%) были отнесены к I функциональному классу хронической сердечной недостаточности по шкале Нью-Йоркской кардиологической ассоциации. Кардиореабилитационные программы с использованием аэробных физических тренировок на велоэргометре начинали проводить через 4 нед после АКШ. Физическая реабилитация с использованием аэробных кардиореспираторных физических упражнений – велотренировок – проводилась в течение 4–7 нед по 150 мин в неделю.
Результаты. У больных после АКШ достоверно улучшались показатели кардиореспираторного теста и некоторые эхокардиографические параметры после 3-недельного и 7-недельного цикла аэробных кардиореспираторных тренировок (КРТ), при этом в большей степени в группе высокоинтенсивных интервальных физических тренировок, чем в группе постоянных тренировок средней интенсивности. Это были показатели пикового потребления кислорода, частоты сердечных сокращений, мощности нагрузки, конечно-диастолического объема и фракции выброса левого желудочка. Также к концу 7-недельного цикла КРТ достоверно снижался индекс массы тела, в большей степени в группе высокоинтенсивных интервальных физических тренировок. Интересна динамика лабораторных показателей: увеличивался уровень липопротеидов высокой плотности в обеих группах, при этом коэффициент атерогенности не менялся. Также через 7 нед тренировок достоверно снижался уровень триглицеридов. Полученные нами сведения подтверждают тот факт, что аэробные КРТ улучшают биогенез митохондрий, липидный профиль, кровяное давление и способствуют уменьшению абдоминального ожирения.
Заключение. Аэробные высокоинтенсивные интервальные физические тренировки так же безопасны в рамках программы кардиореабилитации у больных после операций на открытом сердце, как и постоянные аэробные тренировки умеренной интенсивности.
Ключевые слова: аэробные кардиореспираторные тренировки высокой и средней интенсивности, аортокоронарное шунтирование, кардиореабилитация
Material and methods. 137 patients after CABG were included in the study. 90.4% of patients were consider as class I of chronic heart failure after surgery. Cardiorespiratory trainings were initiate in 4 weeks after surgery, using cycling by veloergometers. Two groups were compare according to rehabilitation programs: one carried out constant aerobic trainings of moderate and medium intensity, and the other, aerobic high-intensity interval trainings. Supervised trainings were carry out for 150 minutes per week. Total length of trainings was 4–7 weeks. Long-term trainings were distantly monitore.
Results. Ergospirometric results as well as results of echocardiography were significantly improve after training course. These results were more significant in high-intensity interval training group, compared to moderate intensity-training group. VO2, heart rate and training power significantly improved. Body mass index significantly diminished in high-intensity interval training group, compared to moderate intensity-training group. In 7 weeks after training ominously decreased blood triglycerides and increased high-density lipoproteins.
Conclusion. Cardiorespiratory trainings ameliorate mitochondrial biogenesis, carbohydrate and lipid metabolism, promote to reduce abdominal obesity and other crucial risk factors of coronary patients. Aerobic high-intensity interval cardiac trainings are as safe as moderate intensity cardiac trainings, and in some issues, they outperform moderate intensity cardiac trainings.
Keywords: aerobic cardiorespiratory trainings, high intensity interval trainings, low and moderate intensity cardiac trainings, coronary artery bypass surgery, cardiac rehabilitation
Материал и методы. В исследование вошли 137 пациентов после аортокоронарного шунтирования (АКШ). Проводилось сравнение групп пациентов по программам реабилитационных мероприятий: одной группе проводились постоянные аэробные тренировки умеренной и средней интенсивности, другой – аэробные высокоинтенсивные интервальные физические тренировки. Подавляющее большинство пациентов после АКШ (90,4%) были отнесены к I функциональному классу хронической сердечной недостаточности по шкале Нью-Йоркской кардиологической ассоциации. Кардиореабилитационные программы с использованием аэробных физических тренировок на велоэргометре начинали проводить через 4 нед после АКШ. Физическая реабилитация с использованием аэробных кардиореспираторных физических упражнений – велотренировок – проводилась в течение 4–7 нед по 150 мин в неделю.
Результаты. У больных после АКШ достоверно улучшались показатели кардиореспираторного теста и некоторые эхокардиографические параметры после 3-недельного и 7-недельного цикла аэробных кардиореспираторных тренировок (КРТ), при этом в большей степени в группе высокоинтенсивных интервальных физических тренировок, чем в группе постоянных тренировок средней интенсивности. Это были показатели пикового потребления кислорода, частоты сердечных сокращений, мощности нагрузки, конечно-диастолического объема и фракции выброса левого желудочка. Также к концу 7-недельного цикла КРТ достоверно снижался индекс массы тела, в большей степени в группе высокоинтенсивных интервальных физических тренировок. Интересна динамика лабораторных показателей: увеличивался уровень липопротеидов высокой плотности в обеих группах, при этом коэффициент атерогенности не менялся. Также через 7 нед тренировок достоверно снижался уровень триглицеридов. Полученные нами сведения подтверждают тот факт, что аэробные КРТ улучшают биогенез митохондрий, липидный профиль, кровяное давление и способствуют уменьшению абдоминального ожирения.
Заключение. Аэробные высокоинтенсивные интервальные физические тренировки так же безопасны в рамках программы кардиореабилитации у больных после операций на открытом сердце, как и постоянные аэробные тренировки умеренной интенсивности.
Ключевые слова: аэробные кардиореспираторные тренировки высокой и средней интенсивности, аортокоронарное шунтирование, кардиореабилитация
________________________________________________
Material and methods. 137 patients after CABG were included in the study. 90.4% of patients were consider as class I of chronic heart failure after surgery. Cardiorespiratory trainings were initiate in 4 weeks after surgery, using cycling by veloergometers. Two groups were compare according to rehabilitation programs: one carried out constant aerobic trainings of moderate and medium intensity, and the other, aerobic high-intensity interval trainings. Supervised trainings were carry out for 150 minutes per week. Total length of trainings was 4–7 weeks. Long-term trainings were distantly monitore.
Results. Ergospirometric results as well as results of echocardiography were significantly improve after training course. These results were more significant in high-intensity interval training group, compared to moderate intensity-training group. VO2, heart rate and training power significantly improved. Body mass index significantly diminished in high-intensity interval training group, compared to moderate intensity-training group. In 7 weeks after training ominously decreased blood triglycerides and increased high-density lipoproteins.
Conclusion. Cardiorespiratory trainings ameliorate mitochondrial biogenesis, carbohydrate and lipid metabolism, promote to reduce abdominal obesity and other crucial risk factors of coronary patients. Aerobic high-intensity interval cardiac trainings are as safe as moderate intensity cardiac trainings, and in some issues, they outperform moderate intensity cardiac trainings.
Keywords: aerobic cardiorespiratory trainings, high intensity interval trainings, low and moderate intensity cardiac trainings, coronary artery bypass surgery, cardiac rehabilitation
Полный текст
Список литературы
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2. Guyton AC, Jones CE, Coleman TB. Circulatory Physiology: Cardiac Output and ITS Regulation. Philadelphia: WB Saunders Co, 1973.
3. Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2016;18:891-975. DOI:10.1002/ejhf.592
4. Nilsson BB, Westheim A, Risberg MA. Long-term effects of a group-based high-intensity aerobic interval-training program in patients with chronic heart failure. Am J Cardiol. 2008;102(9):1220-4. DOI:10.1016/j.amjcard.2008.06.046
5. Piña IL, Apstein CS, Balady GJ, et al. Exercise and heart failure: a statement from the American Heart Association Committee on Exercise, Rehabilitation, and Prevention. Circulation. 2003;107(8):1210-25.
DOI:10.1161/01.cir.0000055013.92097.40
6. O’Connor CM, Whellan DJ, Lee KM, et al. Efficacy and Safety of Exercise Training in Patients With Chronic Heart Failure: HF-ACTION Randomized Controlled Trial. JAMA. 2009;301(14):1439-50. DOI:10.1001/jama.2009.454
7. Benito B, Nattel S. Exercise training as a treatment for heart failure: Potential mechanisms and clinical implications. J Physiol.
2009;587(Pt. 21):5011-3. DOI:10.1113/jphysiol.2009.181339
8. Niebauer J. Is There a Role for Cardiac Rehabilitation After Coronary Artery Bypass Grafting? Treatment After Coronary Artery Bypass Surgery Remains Incomplete Without Rehabilitation. Circulation. 2016;133:2529-37.
DOI:10.1161/CIRCULATIONAHA.116.021348
9. Sovremennye aspekty kardioreabilitatsii. Ed. TT Kakuchaia. Moscow: NTsSSKh im. A.N. Bakuleva, 2015 (in Russian).
10. Kardioreabilitatsiia i vtorichnaia profilaktika. Ed. DM Aronov. Moscow: GEOTAR-Media, 2021 (in Russian).
11. Guiraud T, Nigam A, Gremeaux V, et al. High-intensity interval training in cardiac rehabilitation. Sports Med. 2012;42(7):587-605.
DOI:10.2165/11631910-000000000-00000
12. Juneau M, Hayami D, Gayda M, et al. Provocative issues in heart disease prevention. Can J Cardiol. 2014;30(Suppl. 12):S401-9.
DOI:10.1016/j.cjca.2014.09.014
13. Wewege MA, Ahn D, Yu J, et al. High-Intensity Interval Training for Patients With Cardiovascular Disease – Is It Safe? A Systematic Review. J Am Heart Assoc. 2018;7:e009305. DOI:10.1161/JAHA.118.009305
14. Moholdt TT, Amundsen BH, Rustad LA, et al. Aerobic interval training versus continuous moderate exercise after coronary artery bypass surgery: a randomized study of cardiovascular effects and quality of life. Am Heart J. 2009;158(6):1031-7. DOI:10.1016/j.ahj.2009.10.003
15. Keteyian SJ, Hibner BA, Bronsteen K, et al. Greater improvement in cardiorespiratory fitness using higher-intensity interval training in the standard cardiac rehabilitation setting. J Cardiopulm Rehabil Prev. 2014;34(2):98-105. DOI:10.1097/HCR.0000000000000049
16. Pattyn N, Coeckelberghs E, Buys R, et al. Aerobic interval training vs. moderate continuous training in coronary artery disease patients: a systematic review and meta-analysis. Sports Med. 2014;44(5):687-700. DOI:10.1007/s40279-014-0158-x
17. Pescatello L, Arena R, Riebe D, Thompson P. General Principles of Exercise Prescription. In: ACSM’s Guidelines for Exercise Testing and Prescription. 9th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2013; p. 166-77.
18. Bokeriya LA, Aronov DM, et al. Russian clinical guidelines. Coronary artery bypass grafting in patients with ischemic heart disease: rehabilitation and secondary prevention. Cardiosomatics. 2016;7(3-4):5-71 (in Russian).
DOI:10.26442/CS45210
19. Pachuashvili NV. Effektivnost' sovremennykh aerobnykh interval'nykh fizicheskikh trenirovok v reabilitatsii vzroslykh bol'nykh posle operatsii na otkrytom serdtse. Dis. … kand. med. nauk. Moscow, 2019 (in Russian).
20. Conraads VM, Pattyn N, De Maeyer C, et al. Aerobic interval training and continuous training equally improve aerobic exercise capacity in patients with coronary artery disease: The SAINTEX-CAD study. Int J Cardiol. 2015;179:203-10. DOI:10.1016/j.ijcard.2014.10.155
21. Price KJ, Gordon BA, Bird SR, Benson AC. A review of guidelines for cardiac rehabilitation exercise programmes: is there an international consensus? Eur J Prev Cardiol. 2016;23(16):1715-33. DOI:10.1177/2047487316657669
22. Hannan AL, Hing W, Simas V, et al. High-intensity interval training versus moderate-intensity continuous training within cardiac rehabilitation: a systematic review and meta-analysis. Open Access J Sports Med.
2018;9:1-17. DOI:10.2147/OAJSM.S150596
23. Dibben GO, Dalal HM, Taylor RS, et al. Cardiac rehabilitation and physical activity: systematic review and meta-analysis. Heart. 2018;104(17):1394-402. DOI:10.1136/heartjnl-2017-312832
24. Wickramasinghe CD, Ayers CR, Das S, et al. Prediction of 30-year risk for cardiovascular mortality by fitness and risk factor levels: the Cooper Center Longitudinal Study. Circ Cardiovasc Qual Outcomes. 2014;7:597-602. DOI:10.1161/CIRCOUTCOMES.113.000531
25. Radford NB, DeFina LF, Leonard D, et al. Cardiorespiratory fitness, coronary artery calcium, and cardiovascular disease events in a cohort of generally healthy middle-age men: results from the Cooper Center Longitudinal Study. Circulation. 2018;137:1888-95. DOI:10.1161/CIRCULATIONAHA.117.032708
26. Thompson PD, Franklin BA, Balady GJ, et al.; American Heart Association Council on Nutrition, Physical Activity, and Metabolism; American Heart Association Council on Clinical Cardiology; American College of Sports Medicine. Exercise and acute cardiovascular events placing the risks into perspective: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism and the Council on Clinical Cardiology. Circulation. 2007;115:2358-68. DOI:10.1161/CIRCULATIONAHA.107.181485
27. Cobb LA, Weaver WD. Exercise: a risk for sudden death in patients with coronary heart disease. J Am Coll Cardiol. 1986;7:215-9.
DOI:10.1016/s0735-1097(86)80284-4
28. Levinger I, Shaw CS, Stepto NK, et al. What doesn’t kill you makes you fitter: a systematic review of high-intensity interval exercise for patients with cardiovascular and metabolic diseases. Clin Med Insights Cardiol.
2015;9:53-63. DOI:10.4137/CMC.S26230
29. Rognmo Ø, Moholdt T, Bakken H, et al. Cardiovascular risk of high-versus moderate-intensity aerobic exercise in coronary heart disease patients. Circulation. 2012;126:1436-40. DOI:10.1161/CIRCULATIONAHA.112.123117
30. Quindry JC, Franklin BA, Chapman M, et al. Benefits and risks of high-intensity interval training in patients with coronary artery disease. Am J Cardiol. 2019;123:1370-7. DOI:10.1016/j.amjcard.2019.01.008
31. Williams PT, Thompson PD. Increased cardiovascular disease mortality associated with excessive exercise in heart attack survivors. Mayo Clin Proc. 2014;89:1187-94. DOI:10.1016/j.mayocp.2014.05.006
32. Keteyian SJ, Leifer ES, Houston-Miller N, et al.; HFACTION Investigators. Relation between volume of exercise and clinical outcomes in patients with heart failure. J Am Coll Cardiol. 2012;60(19):1899-905. DOI:10.1016/j.jacc.2012.08.958
33. Wannamethee SG, Shaper AG. Physical activity and cardiovascular disease. Semin Vasc Med. 2002;2(3):257-66. DOI:10.1055/s-2002-35400
34. Mons U, Hahmann H, Brenner H. A reverse J-shaped association of leisure time physical activity with prognosis in patients with stable coronary heart disease: evidence from a large cohort with repeated measurements. Heart. 2014;100(13):1043-9. DOI:10.1136/heartjnl-2013-305242
35. Stewart RAH, Held C, Hadziosmanovic N, et al.; STABILITY Investigators. Physical activity and mortality in patients with stable coronary heart disease. J Am Coll Cardiol. 2017;70(14):1689-700. DOI:10.1016/j.jacc.2017.08.017
36. Moholdt T, Wisløff U, Nilsen TIL, Slørdahl SA. Physical activity and mortality in men and women with coronary heart disease: a prospective population-based cohort study in Norway (the HUNT study). Eur J Cardiovasc Prev Rehabil. 2008;15:639-45. DOI:10.1097/HJR.0b013e3283101671
37. Chief Medical Officers. Start active, stay active. A report on physical activity for health from four home countries, 2011. Available at: https://www.gov.uk/goverment/uploads/system/uploads/attachment_data/file/830943/withdrawn_dh_128210..... Accessed: 22.07.2021.
38. Thomas RJ, Beatty AL, Beckie TM, et al. Home-based cardiac rehabilitation: a scientific statement from the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology. Circulation. 2019;140:e69-e89.
DOI:10.1161/CIR.0000000000000663
39. Belardinelli R, Georgiou D, Cianci G, Purcaro A. 10-year exercise training in chronic heart failure: a randomized controlled trial. J Am Coll Cardiol. 2012;60(16):1521-8. DOI:10.1016/j.jacc.2012.06.036
2. Guyton AC, Jones CE, Coleman TB. Circulatory Physiology: Cardiac Output and ITS Regulation. Philadelphia: WB Saunders Co, 1973.
3. Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2016;18:891-975. DOI:10.1002/ejhf.592
4. Nilsson BB, Westheim A, Risberg MA. Long-term effects of a group-based high-intensity aerobic interval-training program in patients with chronic heart failure. Am J Cardiol. 2008;102(9):1220-4. DOI:10.1016/j.amjcard.2008.06.046
5. Piña IL, Apstein CS, Balady GJ, et al. Exercise and heart failure: a statement from the American Heart Association Committee on Exercise, Rehabilitation, and Prevention. Circulation. 2003;107(8):1210-25.
DOI:10.1161/01.cir.0000055013.92097.40
6. O’Connor CM, Whellan DJ, Lee KM, et al. Efficacy and Safety of Exercise Training in Patients With Chronic Heart Failure: HF-ACTION Randomized Controlled Trial. JAMA. 2009;301(14):1439-50. DOI:10.1001/jama.2009.454
7. Benito B, Nattel S. Exercise training as a treatment for heart failure: Potential mechanisms and clinical implications. J Physiol.
2009;587(Pt. 21):5011-3. DOI:10.1113/jphysiol.2009.181339
8. Niebauer J. Is There a Role for Cardiac Rehabilitation After Coronary Artery Bypass Grafting? Treatment After Coronary Artery Bypass Surgery Remains Incomplete Without Rehabilitation. Circulation. 2016;133:2529-37.
DOI:10.1161/CIRCULATIONAHA.116.021348
9. Современные аспекты кардиореабилитации. Под ред. Т.Т. Какучая. М.: НЦССХ им. А.Н. Бакулева, 2015 [Sovremennye aspekty kardioreabilitatsii. Ed. TT Kakuchaia. Moscow: NTsSSKh im. A.N. Bakuleva, 2015 (in Russian)].
10. Кардиореабилитация и вторичная профилактика. Под ред. Д.М. Аронова. М.: ГЭОТАР-Медиа, 2021 [Kardioreabilitatsiia i vtorichnaia profilaktika. Ed. DM Aronov. Moscow: GEOTAR-Media, 2021 (in Russian)].
11. Guiraud T, Nigam A, Gremeaux V, et al. High-intensity interval training in cardiac rehabilitation. Sports Med. 2012;42(7):587-605.
DOI:10.2165/11631910-000000000-00000
12. Juneau M, Hayami D, Gayda M, et al. Provocative issues in heart disease prevention. Can J Cardiol. 2014;30(Suppl. 12):S401-9.
DOI:10.1016/j.cjca.2014.09.014
13. Wewege MA, Ahn D, Yu J, et al. High-Intensity Interval Training for Patients With Cardiovascular Disease – Is It Safe? A Systematic Review. J Am Heart Assoc. 2018;7:e009305. DOI:10.1161/JAHA.118.009305
14. Moholdt TT, Amundsen BH, Rustad LA, et al. Aerobic interval training versus continuous moderate exercise after coronary artery bypass surgery: a randomized study of cardiovascular effects and quality of life. Am Heart J. 2009;158(6):1031-7. DOI:10.1016/j.ahj.2009.10.003
15. Keteyian SJ, Hibner BA, Bronsteen K, et al. Greater improvement in cardiorespiratory fitness using higher-intensity interval training in the standard cardiac rehabilitation setting. J Cardiopulm Rehabil Prev. 2014;34(2):98-105. DOI:10.1097/HCR.0000000000000049
16. Pattyn N, Coeckelberghs E, Buys R, et al. Aerobic interval training vs. moderate continuous training in coronary artery disease patients: a systematic review and meta-analysis. Sports Med. 2014;44(5):687-700. DOI:10.1007/s40279-014-0158-x
17. Pescatello L, Arena R, Riebe D, Thompson P. General Principles of Exercise Prescription. In: ACSM’s Guidelines for Exercise Testing and Prescription. 9th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2013; p. 166-77.
18. Бокерия Л.А., Аронов Д.М., и др. Российские клинические рекомендации. Коронарное шунтирование больных ишемической болезнью сердца: реабилитация и вторичная профилактика. CardioСоматика. 2016;7(3-4):5-71 [Bokeriya LA, Aronov DM, et al. Russian clinical guidelines. Coronary artery bypass grafting in patients with ischemic heart disease: rehabilitation and secondary prevention. Cardiosomatics. 2016;7(3-4):5-71 (in Russian)].
DOI:10.26442/CS45210
19. Пачуашвили Н.В. Эффективность современных аэробных интервальных физических тренировок в реабилитации взрослых больных после операций на открытом сердце. Дис. … канд. мед. наук. М., 2019 [Pachuashvili NV. Effektivnost' sovremennykh aerobnykh interval'nykh fizicheskikh trenirovok v reabilitatsii vzroslykh bol'nykh posle operatsii na otkrytom serdtse. Dis. … kand. med. nauk. Moscow, 2019 (in Russian)].
20. Conraads VM, Pattyn N, De Maeyer C, et al. Aerobic interval training and continuous training equally improve aerobic exercise capacity in patients with coronary artery disease: The SAINTEX-CAD study. Int J Cardiol. 2015;179:203-10. DOI:10.1016/j.ijcard.2014.10.155
21. Price KJ, Gordon BA, Bird SR, Benson AC. A review of guidelines for cardiac rehabilitation exercise programmes: is there an international consensus? Eur J Prev Cardiol. 2016;23(16):1715-33. DOI:10.1177/2047487316657669
22. Hannan AL, Hing W, Simas V, et al. High-intensity interval training versus moderate-intensity continuous training within cardiac rehabilitation: a systematic review and meta-analysis. Open Access J Sports Med.
2018;9:1-17. DOI:10.2147/OAJSM.S150596
23. Dibben GO, Dalal HM, Taylor RS, et al. Cardiac rehabilitation and physical activity: systematic review and meta-analysis. Heart. 2018;104(17):1394-402. DOI:10.1136/heartjnl-2017-312832
24. Wickramasinghe CD, Ayers CR, Das S, et al. Prediction of 30-year risk for cardiovascular mortality by fitness and risk factor levels: the Cooper Center Longitudinal Study. Circ Cardiovasc Qual Outcomes. 2014;7:597-602. DOI:10.1161/CIRCOUTCOMES.113.000531
25. Radford NB, DeFina LF, Leonard D, et al. Cardiorespiratory fitness, coronary artery calcium, and cardiovascular disease events in a cohort of generally healthy middle-age men: results from the Cooper Center Longitudinal Study. Circulation. 2018;137:1888-95. DOI:10.1161/CIRCULATIONAHA.117.032708
26. Thompson PD, Franklin BA, Balady GJ, et al.; American Heart Association Council on Nutrition, Physical Activity, and Metabolism; American Heart Association Council on Clinical Cardiology; American College of Sports Medicine. Exercise and acute cardiovascular events placing the risks into perspective: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism and the Council on Clinical Cardiology. Circulation. 2007;115:2358-68. DOI:10.1161/CIRCULATIONAHA.107.181485
27. Cobb LA, Weaver WD. Exercise: a risk for sudden death in patients with coronary heart disease. J Am Coll Cardiol. 1986;7:215-9.
DOI:10.1016/s0735-1097(86)80284-4
28. Levinger I, Shaw CS, Stepto NK, et al. What doesn’t kill you makes you fitter: a systematic review of high-intensity interval exercise for patients with cardiovascular and metabolic diseases. Clin Med Insights Cardiol.
2015;9:53-63. DOI:10.4137/CMC.S26230
29. Rognmo Ø, Moholdt T, Bakken H, et al. Cardiovascular risk of high-versus moderate-intensity aerobic exercise in coronary heart disease patients. Circulation. 2012;126:1436-40. DOI:10.1161/CIRCULATIONAHA.112.123117
30. Quindry JC, Franklin BA, Chapman M, et al. Benefits and risks of high-intensity interval training in patients with coronary artery disease. Am J Cardiol. 2019;123:1370-7. DOI:10.1016/j.amjcard.2019.01.008
31. Williams PT, Thompson PD. Increased cardiovascular disease mortality associated with excessive exercise in heart attack survivors. Mayo Clin Proc. 2014;89:1187-94. DOI:10.1016/j.mayocp.2014.05.006
32. Keteyian SJ, Leifer ES, Houston-Miller N, et al.; HFACTION Investigators. Relation between volume of exercise and clinical outcomes in patients with heart failure. J Am Coll Cardiol. 2012;60(19):1899-905. DOI:10.1016/j.jacc.2012.08.958
33. Wannamethee SG, Shaper AG. Physical activity and cardiovascular disease. Semin Vasc Med. 2002;2(3):257-66. DOI:10.1055/s-2002-35400
34. Mons U, Hahmann H, Brenner H. A reverse J-shaped association of leisure time physical activity with prognosis in patients with stable coronary heart disease: evidence from a large cohort with repeated measurements. Heart. 2014;100(13):1043-9. DOI:10.1136/heartjnl-2013-305242
35. Stewart RAH, Held C, Hadziosmanovic N, et al.; STABILITY Investigators. Physical activity and mortality in patients with stable coronary heart disease. J Am Coll Cardiol. 2017;70(14):1689-700. DOI:10.1016/j.jacc.2017.08.017
36. Moholdt T, Wisløff U, Nilsen TIL, Slørdahl SA. Physical activity and mortality in men and women with coronary heart disease: a prospective population-based cohort study in Norway (the HUNT study). Eur J Cardiovasc Prev Rehabil. 2008;15:639-45. DOI:10.1097/HJR.0b013e3283101671
37. Chief Medical Officers. Start active, stay active. A report on physical activity for health from four home countries, 2011. Available at: https://www.gov.uk/goverment/uploads/system/uploads/attachment_data/file/830943/withdrawn_dh_128210..... Accessed: 22.07.2021.
38. Thomas RJ, Beatty AL, Beckie TM, et al. Home-based cardiac rehabilitation: a scientific statement from the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology. Circulation. 2019;140:e69-e89.
DOI:10.1161/CIR.0000000000000663
39. Belardinelli R, Georgiou D, Cianci G, Purcaro A. 10-year exercise training in chronic heart failure: a randomized controlled trial. J Am Coll Cardiol. 2012;60(16):1521-8. DOI:10.1016/j.jacc.2012.06.036
________________________________________________
2. Guyton AC, Jones CE, Coleman TB. Circulatory Physiology: Cardiac Output and ITS Regulation. Philadelphia: WB Saunders Co, 1973.
3. Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2016;18:891-975. DOI:10.1002/ejhf.592
4. Nilsson BB, Westheim A, Risberg MA. Long-term effects of a group-based high-intensity aerobic interval-training program in patients with chronic heart failure. Am J Cardiol. 2008;102(9):1220-4. DOI:10.1016/j.amjcard.2008.06.046
5. Piña IL, Apstein CS, Balady GJ, et al. Exercise and heart failure: a statement from the American Heart Association Committee on Exercise, Rehabilitation, and Prevention. Circulation. 2003;107(8):1210-25.
DOI:10.1161/01.cir.0000055013.92097.40
6. O’Connor CM, Whellan DJ, Lee KM, et al. Efficacy and Safety of Exercise Training in Patients With Chronic Heart Failure: HF-ACTION Randomized Controlled Trial. JAMA. 2009;301(14):1439-50. DOI:10.1001/jama.2009.454
7. Benito B, Nattel S. Exercise training as a treatment for heart failure: Potential mechanisms and clinical implications. J Physiol.
2009;587(Pt. 21):5011-3. DOI:10.1113/jphysiol.2009.181339
8. Niebauer J. Is There a Role for Cardiac Rehabilitation After Coronary Artery Bypass Grafting? Treatment After Coronary Artery Bypass Surgery Remains Incomplete Without Rehabilitation. Circulation. 2016;133:2529-37.
DOI:10.1161/CIRCULATIONAHA.116.021348
9. Sovremennye aspekty kardioreabilitatsii. Ed. TT Kakuchaia. Moscow: NTsSSKh im. A.N. Bakuleva, 2015 (in Russian).
10. Kardioreabilitatsiia i vtorichnaia profilaktika. Ed. DM Aronov. Moscow: GEOTAR-Media, 2021 (in Russian).
11. Guiraud T, Nigam A, Gremeaux V, et al. High-intensity interval training in cardiac rehabilitation. Sports Med. 2012;42(7):587-605.
DOI:10.2165/11631910-000000000-00000
12. Juneau M, Hayami D, Gayda M, et al. Provocative issues in heart disease prevention. Can J Cardiol. 2014;30(Suppl. 12):S401-9.
DOI:10.1016/j.cjca.2014.09.014
13. Wewege MA, Ahn D, Yu J, et al. High-Intensity Interval Training for Patients With Cardiovascular Disease – Is It Safe? A Systematic Review. J Am Heart Assoc. 2018;7:e009305. DOI:10.1161/JAHA.118.009305
14. Moholdt TT, Amundsen BH, Rustad LA, et al. Aerobic interval training versus continuous moderate exercise after coronary artery bypass surgery: a randomized study of cardiovascular effects and quality of life. Am Heart J. 2009;158(6):1031-7. DOI:10.1016/j.ahj.2009.10.003
15. Keteyian SJ, Hibner BA, Bronsteen K, et al. Greater improvement in cardiorespiratory fitness using higher-intensity interval training in the standard cardiac rehabilitation setting. J Cardiopulm Rehabil Prev. 2014;34(2):98-105. DOI:10.1097/HCR.0000000000000049
16. Pattyn N, Coeckelberghs E, Buys R, et al. Aerobic interval training vs. moderate continuous training in coronary artery disease patients: a systematic review and meta-analysis. Sports Med. 2014;44(5):687-700. DOI:10.1007/s40279-014-0158-x
17. Pescatello L, Arena R, Riebe D, Thompson P. General Principles of Exercise Prescription. In: ACSM’s Guidelines for Exercise Testing and Prescription. 9th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2013; p. 166-77.
18. Bokeriya LA, Aronov DM, et al. Russian clinical guidelines. Coronary artery bypass grafting in patients with ischemic heart disease: rehabilitation and secondary prevention. Cardiosomatics. 2016;7(3-4):5-71 (in Russian).
DOI:10.26442/CS45210
19. Pachuashvili NV. Effektivnost' sovremennykh aerobnykh interval'nykh fizicheskikh trenirovok v reabilitatsii vzroslykh bol'nykh posle operatsii na otkrytom serdtse. Dis. … kand. med. nauk. Moscow, 2019 (in Russian).
20. Conraads VM, Pattyn N, De Maeyer C, et al. Aerobic interval training and continuous training equally improve aerobic exercise capacity in patients with coronary artery disease: The SAINTEX-CAD study. Int J Cardiol. 2015;179:203-10. DOI:10.1016/j.ijcard.2014.10.155
21. Price KJ, Gordon BA, Bird SR, Benson AC. A review of guidelines for cardiac rehabilitation exercise programmes: is there an international consensus? Eur J Prev Cardiol. 2016;23(16):1715-33. DOI:10.1177/2047487316657669
22. Hannan AL, Hing W, Simas V, et al. High-intensity interval training versus moderate-intensity continuous training within cardiac rehabilitation: a systematic review and meta-analysis. Open Access J Sports Med.
2018;9:1-17. DOI:10.2147/OAJSM.S150596
23. Dibben GO, Dalal HM, Taylor RS, et al. Cardiac rehabilitation and physical activity: systematic review and meta-analysis. Heart. 2018;104(17):1394-402. DOI:10.1136/heartjnl-2017-312832
24. Wickramasinghe CD, Ayers CR, Das S, et al. Prediction of 30-year risk for cardiovascular mortality by fitness and risk factor levels: the Cooper Center Longitudinal Study. Circ Cardiovasc Qual Outcomes. 2014;7:597-602. DOI:10.1161/CIRCOUTCOMES.113.000531
25. Radford NB, DeFina LF, Leonard D, et al. Cardiorespiratory fitness, coronary artery calcium, and cardiovascular disease events in a cohort of generally healthy middle-age men: results from the Cooper Center Longitudinal Study. Circulation. 2018;137:1888-95. DOI:10.1161/CIRCULATIONAHA.117.032708
26. Thompson PD, Franklin BA, Balady GJ, et al.; American Heart Association Council on Nutrition, Physical Activity, and Metabolism; American Heart Association Council on Clinical Cardiology; American College of Sports Medicine. Exercise and acute cardiovascular events placing the risks into perspective: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism and the Council on Clinical Cardiology. Circulation. 2007;115:2358-68. DOI:10.1161/CIRCULATIONAHA.107.181485
27. Cobb LA, Weaver WD. Exercise: a risk for sudden death in patients with coronary heart disease. J Am Coll Cardiol. 1986;7:215-9.
DOI:10.1016/s0735-1097(86)80284-4
28. Levinger I, Shaw CS, Stepto NK, et al. What doesn’t kill you makes you fitter: a systematic review of high-intensity interval exercise for patients with cardiovascular and metabolic diseases. Clin Med Insights Cardiol.
2015;9:53-63. DOI:10.4137/CMC.S26230
29. Rognmo Ø, Moholdt T, Bakken H, et al. Cardiovascular risk of high-versus moderate-intensity aerobic exercise in coronary heart disease patients. Circulation. 2012;126:1436-40. DOI:10.1161/CIRCULATIONAHA.112.123117
30. Quindry JC, Franklin BA, Chapman M, et al. Benefits and risks of high-intensity interval training in patients with coronary artery disease. Am J Cardiol. 2019;123:1370-7. DOI:10.1016/j.amjcard.2019.01.008
31. Williams PT, Thompson PD. Increased cardiovascular disease mortality associated with excessive exercise in heart attack survivors. Mayo Clin Proc. 2014;89:1187-94. DOI:10.1016/j.mayocp.2014.05.006
32. Keteyian SJ, Leifer ES, Houston-Miller N, et al.; HFACTION Investigators. Relation between volume of exercise and clinical outcomes in patients with heart failure. J Am Coll Cardiol. 2012;60(19):1899-905. DOI:10.1016/j.jacc.2012.08.958
33. Wannamethee SG, Shaper AG. Physical activity and cardiovascular disease. Semin Vasc Med. 2002;2(3):257-66. DOI:10.1055/s-2002-35400
34. Mons U, Hahmann H, Brenner H. A reverse J-shaped association of leisure time physical activity with prognosis in patients with stable coronary heart disease: evidence from a large cohort with repeated measurements. Heart. 2014;100(13):1043-9. DOI:10.1136/heartjnl-2013-305242
35. Stewart RAH, Held C, Hadziosmanovic N, et al.; STABILITY Investigators. Physical activity and mortality in patients with stable coronary heart disease. J Am Coll Cardiol. 2017;70(14):1689-700. DOI:10.1016/j.jacc.2017.08.017
36. Moholdt T, Wisløff U, Nilsen TIL, Slørdahl SA. Physical activity and mortality in men and women with coronary heart disease: a prospective population-based cohort study in Norway (the HUNT study). Eur J Cardiovasc Prev Rehabil. 2008;15:639-45. DOI:10.1097/HJR.0b013e3283101671
37. Chief Medical Officers. Start active, stay active. A report on physical activity for health from four home countries, 2011. Available at: https://www.gov.uk/goverment/uploads/system/uploads/attachment_data/file/830943/withdrawn_dh_128210..... Accessed: 22.07.2021.
38. Thomas RJ, Beatty AL, Beckie TM, et al. Home-based cardiac rehabilitation: a scientific statement from the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology. Circulation. 2019;140:e69-e89.
DOI:10.1161/CIR.0000000000000663
39. Belardinelli R, Georgiou D, Cianci G, Purcaro A. 10-year exercise training in chronic heart failure: a randomized controlled trial. J Am Coll Cardiol. 2012;60(16):1521-8. DOI:10.1016/j.jacc.2012.06.036
Авторы
Т.Т. Какучая*, Т.Г. Джитава, Н.В. Пачуашвили, А.М. Куулар, И.И. Домрачева, Н.Э. Закарая
ФГБУ «Национальный медицинский исследовательский центр сердечно-сосудистой хирургии им. А.Н. Бакулева» Минздрава России, Москва, Россия
*ttkakuchaya@mail.ru
Bakulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russia
*ttkakuchaya@mail.ru
ФГБУ «Национальный медицинский исследовательский центр сердечно-сосудистой хирургии им. А.Н. Бакулева» Минздрава России, Москва, Россия
*ttkakuchaya@mail.ru
________________________________________________
Bakulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russia
*ttkakuchaya@mail.ru
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