Skip to main content
Erschienen in: CardioVasc 4/2017

16.09.2017 | Chronische Herzinsuffizienz | Fortbildung

Datenlage und Umsetzung im Alltag

Körperliche Aktivität bei Herzinsuffizienz

verfasst von: Prof. Dr. med. Harm Wienbergen, Prof. Dr. med. Rainer Hambrecht

Erschienen in: CardioVasc | Ausgabe 4/2017

Einloggen, um Zugang zu erhalten

Zusammenfassung

Körperliches Training wirkt einer Vielzahl von Pathomechanismen der Herzinsuffizienz, wie der endothelialen Dysfunktion und der neurohumoralen Aktivierung, entgegen und kann somit eine deutliche klinische Verbesserung der Patienten erreichen. Patienten mit Herzinsuf-fizienz sollten deshalb ein individuell angepasstes Trainingsprogramm verordnet bekommen, das nach einer engmaschig überwachten Anfangsphase zunehmend in den Alltag der Patienten integriert wird.
Literatur
1.
Zurück zum Zitat Sullivan MJ, Higginbotham MB, Cobb FR. Exercise training in patients with severe left ventricular dysfunction. Hemodynamic and metabolic effects. Circulation. 1988;78:506–15PubMed Sullivan MJ, Higginbotham MB, Cobb FR. Exercise training in patients with severe left ventricular dysfunction. Hemodynamic and metabolic effects. Circulation. 1988;78:506–15PubMed
2.
Zurück zum Zitat Hambrecht R, Gielen S, Linke A et al. Effects of exercise training on left ventricular function and peripheral resistance in patients with chronic heart failure: A randomized trial. JAMA. 2000;283:3095–101CrossRefPubMed Hambrecht R, Gielen S, Linke A et al. Effects of exercise training on left ventricular function and peripheral resistance in patients with chronic heart failure: A randomized trial. JAMA. 2000;283:3095–101CrossRefPubMed
3.
Zurück zum Zitat Coats AJ, Adamopoulos S, Radaelli A et al. Controlled trial of physical training in chronic heart failure. Exercise performance, hemodynamics, ventilation, and autonomic function. Circulation. 1992;85:2119–31CrossRefPubMed Coats AJ, Adamopoulos S, Radaelli A et al. Controlled trial of physical training in chronic heart failure. Exercise performance, hemodynamics, ventilation, and autonomic function. Circulation. 1992;85:2119–31CrossRefPubMed
4.
Zurück zum Zitat Braith RW, Welsch MA, Feigenbaum MS et al. Neuroendocrine activation in heart failure is modified by endurance exercise training. J Am Coll Cardiol. 1999;34:1170–5CrossRefPubMed Braith RW, Welsch MA, Feigenbaum MS et al. Neuroendocrine activation in heart failure is modified by endurance exercise training. J Am Coll Cardiol. 1999;34:1170–5CrossRefPubMed
5.
Zurück zum Zitat Hambrecht R, Fiehn E, Weigl C et al. Regular physical exercise corrects endothelial dysfunction and improves exercise capacity in patients with chronic heart failure. Circulation. 1998;98:2709–15CrossRefPubMed Hambrecht R, Fiehn E, Weigl C et al. Regular physical exercise corrects endothelial dysfunction and improves exercise capacity in patients with chronic heart failure. Circulation. 1998;98:2709–15CrossRefPubMed
6.
Zurück zum Zitat Hambrecht R, Fiehn E, Yu J et al. Effects of endurance training on mitochondrial ultrastructure and fiber type distribution in skeletal muscle of patients with stable chronic heart failure. J Am Coll Cardiol. 1997;29:1067–73CrossRefPubMed Hambrecht R, Fiehn E, Yu J et al. Effects of endurance training on mitochondrial ultrastructure and fiber type distribution in skeletal muscle of patients with stable chronic heart failure. J Am Coll Cardiol. 1997;29:1067–73CrossRefPubMed
7.
Zurück zum Zitat Adams V, Linke A, Kränkel N et al. Impact of regular physical activity on the NAD(P)H oxidase and angiotensin receptor system in patients with coronary artery disease. Circulation. 2005;111:555–62CrossRefPubMed Adams V, Linke A, Kränkel N et al. Impact of regular physical activity on the NAD(P)H oxidase and angiotensin receptor system in patients with coronary artery disease. Circulation. 2005;111:555–62CrossRefPubMed
8.
Zurück zum Zitat Linke A, Adams V, Schulze PC et al. Antioxidative effects of exercise training in patients with chronic heart failure: increase in radical scavenger enzyme activity in skeletal muscle. Circulation. 2005;111:1763–70CrossRefPubMed Linke A, Adams V, Schulze PC et al. Antioxidative effects of exercise training in patients with chronic heart failure: increase in radical scavenger enzyme activity in skeletal muscle. Circulation. 2005;111:1763–70CrossRefPubMed
9.
Zurück zum Zitat Hambrecht R, Niebauer J, Fiehn E et al. Physical training in patients with stable chronic heart failure: effects on cardiorespiratory fitness and ultrastructural abnormalities of leg muscles. J Am Coll Cardiol. 1995;25:1239–49CrossRefPubMed Hambrecht R, Niebauer J, Fiehn E et al. Physical training in patients with stable chronic heart failure: effects on cardiorespiratory fitness and ultrastructural abnormalities of leg muscles. J Am Coll Cardiol. 1995;25:1239–49CrossRefPubMed
10.
Zurück zum Zitat Gielen S, Adams V, Möbius-Winkler S et al. Anti-inflammatory effects of exercise training in the skeletal muscle of patients with chronic heart failure. J Am Coll Cardiol. 2003;42:861–8CrossRefPubMed Gielen S, Adams V, Möbius-Winkler S et al. Anti-inflammatory effects of exercise training in the skeletal muscle of patients with chronic heart failure. J Am Coll Cardiol. 2003;42:861–8CrossRefPubMed
11.
Zurück zum Zitat Piepoli MF, Davos C, Francis DP, Coats AJ. Exercise training meta-analysis of trials in patients with chronic heart failure (ExTraMATCH). BMJ. 2004; 328:189CrossRefPubMed Piepoli MF, Davos C, Francis DP, Coats AJ. Exercise training meta-analysis of trials in patients with chronic heart failure (ExTraMATCH). BMJ. 2004; 328:189CrossRefPubMed
12.
Zurück zum Zitat Taylor RS, Sagar VA, Davies EJ et al. Exercise-based rehabilitation for heart failure. Cochrane Database Syst Rev. 2014;4:CD003331 Taylor RS, Sagar VA, Davies EJ et al. Exercise-based rehabilitation for heart failure. Cochrane Database Syst Rev. 2014;4:CD003331
13.
Zurück zum Zitat O'Connor CM, Whellan DJ, Lee KL et al. Efficacy and safety of exercise training in patients with chronic heart failure: HF-ACTION randomized controlled trial. JAMA. 2009;301:1439–50CrossRefPubMedPubMedCentral O'Connor CM, Whellan DJ, Lee KL et al. Efficacy and safety of exercise training in patients with chronic heart failure: HF-ACTION randomized controlled trial. JAMA. 2009;301:1439–50CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Erbs S, Höllriegel R, Linke A et al. Exercise training in patients with advanced chronic heart failure (NYHA IIIb) promotes restoration of peripheral vasomotor function, induction of endogenous regeneration, and improvement of left ventricular function. Circ Heart Fail. 2010;3:486–94CrossRefPubMed Erbs S, Höllriegel R, Linke A et al. Exercise training in patients with advanced chronic heart failure (NYHA IIIb) promotes restoration of peripheral vasomotor function, induction of endogenous regeneration, and improvement of left ventricular function. Circ Heart Fail. 2010;3:486–94CrossRefPubMed
15.
Zurück zum Zitat Höllriegel R, Winzer EB, Linke A et al. Long-Term Exercise Training in Patients With Advanced Chronic Heart Failure: Sustained benefits on left ventricular performance and exercise capacity. J Cardiopulm Rehabil Prev. 2016;36:117–24CrossRefPubMed Höllriegel R, Winzer EB, Linke A et al. Long-Term Exercise Training in Patients With Advanced Chronic Heart Failure: Sustained benefits on left ventricular performance and exercise capacity. J Cardiopulm Rehabil Prev. 2016;36:117–24CrossRefPubMed
16.
Zurück zum Zitat Edelmann F, Gelbrich G, Düngen HD et al. Exercise training improves exercise capacity and diastolic function in patients with heart failure with preserved ejection fraction: results of the Ex-DHF (Exercise training in Diastolic Heart Failure) pilot study. J Am Coll Cardiol. 2011;58:1780–91CrossRefPubMed Edelmann F, Gelbrich G, Düngen HD et al. Exercise training improves exercise capacity and diastolic function in patients with heart failure with preserved ejection fraction: results of the Ex-DHF (Exercise training in Diastolic Heart Failure) pilot study. J Am Coll Cardiol. 2011;58:1780–91CrossRefPubMed
17.
Zurück zum Zitat Sandri M, Kozarez I, Adams V et al. 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. Eur Heart J. 2012;33:1758–68CrossRefPubMed Sandri M, Kozarez I, Adams V et al. 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. Eur Heart J. 2012;33:1758–68CrossRefPubMed
18.
Zurück zum Zitat Ponikowski P, Voors AA, Anker S et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2016;37:2129–200CrossRefPubMed Ponikowski P, Voors AA, Anker S et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2016;37:2129–200CrossRefPubMed
19.
Zurück zum Zitat Piepoli MF, Conraads V, Corrà U et al. Exercise training in heart failure: from theory to practice. A consensus document of the Heart Failure Association and the European Association for Cardiovascular Prevention and Rehabilitation. Eur J Heart Fail. 2011;13:347–57PubMed Piepoli MF, Conraads V, Corrà U et al. Exercise training in heart failure: from theory to practice. A consensus document of the Heart Failure Association and the European Association for Cardiovascular Prevention and Rehabilitation. Eur J Heart Fail. 2011;13:347–57PubMed
20.
Zurück zum Zitat Corrà U, Piepoli MF, Adamopoulos S et al. Cardiopulmonary exercise testing in systolic heart failure in 2014: the evolving prognostic role: a position paper from the committee on exercise physiology and training of the heart failure association of the ESC. Eur J Heart Fail. 2014;16:929–41CrossRefPubMed Corrà U, Piepoli MF, Adamopoulos S et al. Cardiopulmonary exercise testing in systolic heart failure in 2014: the evolving prognostic role: a position paper from the committee on exercise physiology and training of the heart failure association of the ESC. Eur J Heart Fail. 2014;16:929–41CrossRefPubMed
21.
Zurück zum Zitat Ismail H, McFarlane JR, Nojoumian AH et al. Clinical outcomes and cardiovascular responses to different exercise training intensities in patients with heart failure: a systematic review and meta-analysis. JACC Heart Fail. 2013;1:514–22CrossRefPubMed Ismail H, McFarlane JR, Nojoumian AH et al. Clinical outcomes and cardiovascular responses to different exercise training intensities in patients with heart failure: a systematic review and meta-analysis. JACC Heart Fail. 2013;1:514–22CrossRefPubMed
22.
Zurück zum Zitat Ellingsen Ø, Halle M, Conraads V et al. High-Intensity Interval Training in Patients With Heart Failure With Reduced Ejection Fraction. Circulation. 2017;135:839–49CrossRefPubMedPubMedCentral Ellingsen Ø, Halle M, Conraads V et al. High-Intensity Interval Training in Patients With Heart Failure With Reduced Ejection Fraction. Circulation. 2017;135:839–49CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Mandic S, Myers J, Selig SE, Levinger I. Resistance versus aerobic exercise training in chronic heart failure. Curr Heart Fail Rep. 2012;9:57–64CrossRefPubMed Mandic S, Myers J, Selig SE, Levinger I. Resistance versus aerobic exercise training in chronic heart failure. Curr Heart Fail Rep. 2012;9:57–64CrossRefPubMed
24.
Zurück zum Zitat Spruit MA, Eterman RM, Hellwig VA et al. Effects of moderate-to-high intensity resistance training in patients with chronic heart failure. Heart. 2009;95:1399–408CrossRefPubMed Spruit MA, Eterman RM, Hellwig VA et al. Effects of moderate-to-high intensity resistance training in patients with chronic heart failure. Heart. 2009;95:1399–408CrossRefPubMed
25.
Zurück zum Zitat Conraads VM, Deaton C, Piotrowicz E et al. Adherence of heart failure patients to exercise: barriers and possible solutions: a position statement of the Study Group on Exercise Training in Heart Failure of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2012;14:451–8CrossRefPubMed Conraads VM, Deaton C, Piotrowicz E et al. Adherence of heart failure patients to exercise: barriers and possible solutions: a position statement of the Study Group on Exercise Training in Heart Failure of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2012;14:451–8CrossRefPubMed
26.
Zurück zum Zitat Wienbergen H, Stehmeier J, Backhaus T et al. Erfassung und Kontrolle körperlicher Aktivität mit Schrittzählern und Online-Dokumentation in der Sekundärprävention nach Myokardinfarkt. Erste Ergebnisse der IPP-Studie. Clin Res Cardiol. 2016;105(Suppl 1): V919 Wienbergen H, Stehmeier J, Backhaus T et al. Erfassung und Kontrolle körperlicher Aktivität mit Schrittzählern und Online-Dokumentation in der Sekundärprävention nach Myokardinfarkt. Erste Ergebnisse der IPP-Studie. Clin Res Cardiol. 2016;105(Suppl 1): V919
Metadaten
Titel
Datenlage und Umsetzung im Alltag
Körperliche Aktivität bei Herzinsuffizienz
verfasst von
Prof. Dr. med. Harm Wienbergen
Prof. Dr. med. Rainer Hambrecht
Publikationsdatum
16.09.2017
Verlag
Springer Medizin
Erschienen in
CardioVasc / Ausgabe 4/2017
Print ISSN: 1617-4933
Elektronische ISSN: 1618-3851
DOI
https://doi.org/10.1007/s15027-017-1184-z

Weitere Artikel der Ausgabe 4/2017

CardioVasc 4/2017 Zur Ausgabe

Passend zum Thema

ANZEIGE

SGLT-2-Inhibitoren für alle Patient:innen mit chronischer Herzinsuffizienz empfohlen

Das ESC-Leitlinien-Update 2023 bedeutet einen Paradigmenwechsel in der Behandlung der Herzinsuffizienz (HF), denn nun werden SGLT-2i sowohl für HFrEF, als auch für HFmrEF und HFpEF empfohlen. Somit können jetzt alle Patient:innen mit HF von SGLT-2i als zentralem Bestandteil der Therapie profitieren.

ANZEIGE

Dapagliflozin als neue Therapieoption zur Behandlung einer Herzinsuffizienz unabhängig von der Ejektionsfraktion

Dapagliflozin ist nun zur Behandlung aller Patient:innen mit chronischer symptomatischer Herzinsuffizienz zugelassen und bietet somit auch neue Hoffnung für die Therapie von jenen mit HFpEF. In der DELIVER-Studie zeigte der SGLT-2-Inhibitor eine signifikante Reduktion von Herzinsuffizienz-Hospitalisierungen und CV-Todesfällen.

ANZEIGE

ACS-Erstlinientherapie: Konsensbeschluss rät zur DAPT mit Ticagrelor

Ein Konsortium führender Fachgesellschaften erarbeitete jüngst auf Basis umfangreicher Metaanalysen einen Konsens für die Therapie koronarer Herzkrankheiten. Was dabei auffiel: Die duale Plättchenhemmung (DAPT) mit Ticagrelor ist die bevorzugte Therapieoption für das akute Koronarsyndrom (ACS).