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心力衰竭(心衰)是由于心功能障碍引起的运动受限和全身淤血症状为主要表现的综合征,与心脏猝死一样是器质性心脏病终末期的表现。因此,心衰的治疗首先是安静,劳累作为恶化因素是长期禁止的。1988年,Braunwald教科书《Heart Disease》中写到,“充血性心衰的基本治疗是避免体育运动和重体力劳动,在家安静坐着或躺着。”但是1990年代,伴随着运动心脏病学的发展,对于慢性心衰患者就限制日常活动一项认为并不是很妥当的想法已占主流。甚至认为,适当运动可以改善患者的QOL和生命预后。在2005年慢性心衰相关的ACC/AHA诊疗指南中,运动疗法与利尿剂并列为Ⅰ类。日本从2006年4月开始,在心脏大血管康复的适应证中,收载了慢性心衰。因此,本文对心衰的运动疗法、运动生理学的背景及实施方法加以解说。
Heart failure (heart failure) is due to heart dysfunction caused by exercise limitations and systemic congestion symptoms as the main manifestation of the syndrome, as with sudden cardiac death is the manifestation of organic heart disease end-stage. Therefore, the treatment of heart failure is first of all quiet, tired as a deterrent is a long-term prohibition. In 1988, the Braunwald textbook “Heart Disease” wrote that “the basic treatment of congestive heart failure is to avoid physical exercise and heavy physical work, sitting quietly or lying at home.” But in the 1990s, with cardiology Development, for patients with chronic heart failure to limit daily activities One idea that has not been properly considered the mainstream. Even think that proper exercise can improve the patient’s QOL and life expectancy. In the 2005 ACC / AHA guidelines for the treatment of chronic heart failure, exercise therapy and diuretics were classified as category I. Japan from April 2006 onwards, in the indications of cardiac revascularization, chronic heart failure contained. Therefore, this article explains the background and implementation of exercise therapy and exercise physiology of heart failure.