2023+AHA科学声明：射血分数保留型心力衰竭的监督运动训练.pdfVIP

Circulation

AHA/ACCSCIENTIFICSTATEMENT

SupervisedExerciseTrainingforChronicHeart

FailureWithPreservedEjectionFraction:

AScientificStatementFromtheAmericanHeart

AssociationandAmericanCollegeofCardiology

ThisstatementisendorsedbytheHeartFailureSocietyofAmerica,theAmericanAssociationofCardiovascularand

PulmonaryRehabilitation,andtheAmericanAssociationofHeartFailureNurses.

VandanaSachdev,MD,Chair*†;KavitaSharma,MD,ViceChair;StevenJ.Keteyian,PhD;CharinaF.Alcain,DNP,ACNP-BC;

PatriceDesvigne-Nickens,MD†;JeromeL.Fleg,MD,FAHA†;ViorelG.Florea,MD,PhD;BarryA.Franklin,PhD,FAHA;

MayaGuglin,MD,PhD;MartinHalle,MD;EricS.Leifer,PhD†;GurusherPanjrath,MD,FAHA;EmilyA.Tinsley,PhD†;

ReneeP.Wong,PhD†;DalaneW.Kitzman,MD,FAHA*;onbehalfoftheAmericanHeartAssociationHeartFailureand

TransplantationCommitteeoftheCouncilonClinicalCardiology;CouncilonArteriosclerosis,ThrombosisandVascularBiology;

andAmericanCollegeofCardiology

ABSTRACT:Heartfailurewithpreservedejectionfraction(HFpEF)isoneofthemostcommonformsofheartfailure;its

prevalenceisincreasing,andoutcomesareworsening.Affectedpatientsoftenexperiencesevereexertionaldyspnea

anddebilitatingfatigue,aswellaspoorqualityoflife,frequenthospitalizations,andahighmortalityrate.Untilrecently,

mostpharmacologicalinterventiontrialsforHFpEFyieldedneutralprimaryoutcomes.Incontrast,trialsofexercise-based

interventionshaveconsistentlydemonstratedlarge,significant,clinicallymeaningfulimprovementsinsymptoms,objectively

determinedexercisecapacity,andusuallyqualityoflife.Thissuccessmaybeattributed,atleastinpart,tothepleiotropic

effectsofexercise,whichmayfavorablyaffectthefullrangeofabnormalities—peripheralvascular,skeletalmuscle,and

cardiovascular—thatcontributetoexerciseinto