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Herz

, Volume 40, Issue 2, pp 206–214 | Cite as

Körperliches Training als wichtige Komponente der Therapie bei Herzinsuffizienz

  • M. DörrEmail author
  • M. Halle
Schwerpunkt

Zusammenfassung

Körperliches Training hat sich als Behandlungsoption der chronisch-stabilen Herzinsuffizienz in den aktuellen Leitlinien etabliert. Es ist aber immer noch eine unterschätzte und in der täglichen Praxis zu wenig eingesetzte Therapieform, obwohl zahlreiche Studien und Metaanalysen konsistent eine Verbesserung von körperlicher Belastbarkeit, Symptomen, Lebensqualität und kardiovaskulärer Hospitalisierungsrate belegen konnten. Grundvoraussetzungen für eine Trainingstherapie sind eine spezifische Voruntersuchung sowie eine optimale leitliniengerechte medikamentöse Therapie und klinische Stabilität seit mindestens 6 Wochen. Als wirksam haben sich ein kontinuierliches Ausdauertraining und in neueren Studien auch ein Ausdauertraining nach Intervallmethode erwiesen, welches durch ein Muskelaktivierungstraining ergänzt werden sollte. Für den klinischen Alltag und für zukünftige Forschungsprojekte besteht eine wichtige Herausforderung darin, Konzepte zu entwickeln, die das Erreichen einer langfristigen Therapieadhärenz ermöglichen, da ein klarer Zusammenhang zwischen Therapievolumen/-dauer und dem zu erwartenden Effekt besteht.

Schlüsselwörter

Chronische Herzinsuffizienz Ausdauertraining Intervalltraining Krafttraining Adhärenz 

Exercise training as a key component of heart failure therapy

Abstract

Physical exercise has been recognized as a standard therapy in the guidelines for secondary prevention of chronic heart failure. In clinical practice its benefits are widely underestimated. It is still too rarely applied as a therapeutic component, despite overwhelming scientific evidence, including meta-analyses illustrating the positive effect on exercise capacity, quality of life and hospitalization. It is crucial that patients undergo a thorough clinical investigation, including exercise testing and are in a clinically stable condition for at least 6 weeks under optimal guideline-conform medicinal therapy before exercise training is initiated. Moreover, it is important that only approved exercise regimens should be prescribed and exercise sessions should be appropriately monitored. Both moderate continuous endurance training and recently developed interval training have been shown to be safe and effective in chronic heart failure. Ideally, endurance training should be combined with moderate resistance training. Current evidence clearly demonstrates a dose-response relationship in the way that beneficial effects of exercise training are strongly related to factors such as exercise duration and intensity. Development of strategies that support long-term adherence to exercise training are a crucial challenge for both daily practice and future research.

Keywords

Chronic heart failure Endurance training Interval training Resistance training Adherence 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt. M. Dörr und M. Halle geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Copyright information

© Urban & Vogel 2015

Authors and Affiliations

  1. 1.Klinik und Poliklinik für Innere Medizin B, AG Kardiovaskuläre Epidemiologie und PräventionUniversitätsmedizin GreifswaldGreifswaldDeutschland
  2. 2.Deutsches Zentrum für Herz-Kreislauf-Forschung, Standort GreifswaldGreifswaldDeutschland
  3. 3.Präventive und Rehabilitative SportmedizinKlinikum rechts der Isar, Technische Universität MünchenMünchenDeutschland
  4. 4.Deutsches Zentrum für Herz-Kreislauf-Forschung, Standort München (Munich Heart Alliance)MünchenDeutschland
  5. 5.Else-Kröner-Fresenius-Zentrum (EKFZ)MünchenDeutschland

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