BackgroundIn patients with coronary heart disease (CHD), individualized exercise training (ET) programs are strongly recommended to optimize peak oxygen uptake (O2peak) improvement and prognosis. However, the cardiac hemodynamic factors responsible for a positive response to training remain unclear. The aim of this study was to compare cardiac hemodynamic changes after an ET program in responder (R) versus non‐responder (NR) CHD patients.MethodsA total of 72 CHD patients completed a 3‐month ET program and were assessed by cycle ergometer cardiopulmonary exercise test (CPET: O2peak assessment) with impedance cardiography (ICG) for hemodynamic measurements before and after training. Cardiac hemodynamics (e.g., CO, CI, SV, ESV, EDV, and SVR) were measured by ICG during CPET. The R and NR groups were classified using the median change in O2peak (>the median for R and ≤the median for NR).ResultsIn the R group, O2peak (+17%, p < 0.001), CO, CI, SV, and HR increased by 17%, 17%, 13%, and 5%, respectively (p < 0.05) after the training program. In the NR group, O2peak, CO, CI, and SV increased by 0.5%, 5%, 8%, and 6%, respectively (p < 0.01). The SVR decreased in both groups (−19% in R and −11% in NR, p < 0.001).ConclusionAmong CHD patients, the R group showed a better improvement in peak cardiac output via an increase in peak stroke volume and heart rate and a reduced systemic vascular resistance than the NR group. Different cardiac phenotype adaptations and clinical individual responses were identified in CHD patients according to the aerobic fitness responder's status.

中文翻译：

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冠心病患者心脏血流​​动力学表型和个体对训练的反应

背景强烈建议患有冠心病 (CHD) 的患者进行个体化运动训练 (ET) 计划，以优化峰值摄氧量 (O2峰) 改善和预后。然而，导致对训练产生积极反应的心脏血流动力学因素仍不清楚。本研究的目的是比较有反应者 (R) 与无反应者 (NR) CHD 患者在 ET 计划后心脏血流动力学的变化。 方法 共有 72 名 CHD 患者完成了 3 个月的 ET 计划，并通过自行车测力计心肺功能进行评估运动测试（CPET：O2峰评估）与阻抗心动图（ICG）进行训练前后的血流动力学测量。在 CPET 期间通过 ICG 测量心脏血流动力学（例如 CO、CI、SV、ESV、EDV 和 SVR）。 R 组和 NR 组使用 O 的中值变化进行分类2峰（> R 的中位数且 ≤ NR 的中位数）。结果在 R 组中，O2峰（+17%，p< 0.001)，CO、CI、SV 和 HR 分别增加 17%、17%、13% 和 5%（p< 0.05) 训练计划结束后。在 NR 组中，O2峰、CO、CI 和 SV 分别增加 0.5%、5%、8% 和 6%（p< 0.01）。两组的 SVR 均下降（R 组为 -19%，NR 组为 -11%，p< 0.001)。 结论 在 CHD 患者中，R 组通过增加峰值每搏输出量和心率以及降低全身血管阻力，比 NR 组显示出更好的峰值心输出量改善。根据有氧健身反应者的状态，在先心病患者中确定了不同的心脏表型适应和临床个体反应。