Skip to main content
SpringerLink
Log in

Training als therapie voor patiënten met hartfalen

  • Published:
Bijblijven

Samenvatting

Oefentherapie kan bij patiënten met hartfalen voor een verlaging van het aantal ziekenhuisopnames zorgen en de kwaliteit van leven verbeteren. Thuis trainen met behulp van telemonitoring en coaching lijkt daarbij even effectief als een oefenprogramma in een revalidatiecentrum. Een trainingsvolume overeenkomend met de helft tot twee derde van de Nederlandse norm voor gezond bewegen lijkt optimaal om het risico van een ongeplande opname of sterfte te verminderen en meer is mogelijk contraproductief. Indien er een voorkeur bestaat voor laag-intensief trainen dan lijkt het ophogen van de trainingsfrequentie en de trainingstijd het meest effectief om het inspanningsvermogen te verbeteren. Alhoewel een hogere trainingsintensiteit een grotere verbetering lijkt te geven van het inspanningsvermogen, is dit effect van inspanningen met een hartslag boven 80 % van de maximale hartslag niet meer aannemelijk. Krachttraining is een effectieve manier om zowel de kracht als het inspanningsvermogen te verbeteren en lijkt vooral nuttig bij patiënten die niet meer in staat zijn om een inspanning gedurende lange tijd vol te houden.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatuur

  1. Harrington D, Anker SD, Chua TP, Webb-Peploe KM, Ponikowski PP, Poole-Wilson PA, et al. Skeletal muscle function and its relation to exercise tolerance in chronic heart failure. J Am Coll Cardiol. 1997;30(7):1758–64.

    Article  PubMed  CAS  Google Scholar 

  2. Mancini DM, Walter G, Reichek N, Lenkinski R, McCully KK, Mullen JL, et al. Contribution of skeletal muscle atrophy to exercise intolerance and altered muscle metabolism in heart failure. Circulation. 1992;85(4):1364–73.

    Article  PubMed  CAS  Google Scholar 

  3. Duscha BD, Schulze PC, Robbins JL, Forman DE. Implications of chronic heart failure on peripheral vasculature and skeletal muscle before and after exercise training. Heart Fail Rev. 2008;13(1):21–37.

    Article  PubMed  Google Scholar 

  4. Sinoway LI, Li J. A perspective on the muscle reflex: implications for congestive heart failure. J Appl Physiol. 1985;99(1):5–22.

    Article  CAS  Google Scholar 

  5. Schaufelberger M, Eriksson BO, Grimby G, Held P, Swedberg K. Skeletal muscle alterations in patients with chronic heart failure. Eur Heart J. 1997;18(6):971–80.

    Article  PubMed  CAS  Google Scholar 

  6. Drexler H, Riede U, Munzel T, Konig H, Funke E, Just H. Alterations of skeletal muscle in chronic heart failure. Circulation. 1992;85(5):1751–9.

    Article  PubMed  CAS  Google Scholar 

  7. Middlekauff HR. Making the case for skeletal myopathy as the major limitation of exercise capacity in heart failure. Circ Heart Fail. 2010;3(4):537–46.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Alves MJ, Rondon MU, Santos AC, Dias RG, Barretto AC, Krieger EM, et al. Sympathetic nerve activity restrains reflex vasodilatation in heart failure. Clin Auton Res. 2007;17(6):364–9.

    Article  PubMed  Google Scholar 

  9. Muller-Werdan U, Werdan K. Immune modulation by catecholamines – a potential mechanism of cytokine release in heart failure? Herz. 2000;25(3):271–3.

    Article  PubMed  CAS  Google Scholar 

  10. Gielen S, Adams V, Mobius-Winkler S, Linke A, Erbs S, Yu J, et al. Anti-inflammatory effects of exercise training in the skeletal muscle of patients with chronic heart failure. J Am Coll Cardiol. 2003;42(5):861–8.

    Article  PubMed  CAS  Google Scholar 

  11. Simonini A, Long CS, Dudley GA, Yue P, McElhinny J, Massie BM. Heart failure in rats causes changes in skeletal muscle morphology and gene expression that are not explained by reduced activity. Circ Res. 1996;79(1):128–36.

    Article  PubMed  CAS  Google Scholar 

  12. Sullivan MJ, Higginbotham MB, Cobb FR. Exercise training in patients with severe left ventricular dysfunction. Hemodynamic and metabolic effects. Circulation. 1988;78(3):506–15.

    Article  PubMed  CAS  Google Scholar 

  13. Taylor RS, Sagar VA, Davies EJ, Briscoe S, Coats AJ, Dalal H, et al. Exercise-based rehabilitation for heart failure. Cochrane Database Syst Rev. 2014; https://doi.org/10.1002/14651858.

    Article  PubMed  Google Scholar 

  14. Doukky R, Mangla A, Ibrahim Z, Poulin MF, Avery E, Collado FM, et al. Impact of physical inactivity on mortality in patients with heart failure. Am J Cardiol. 2016;117(7):1135–43.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Bakker EA, Snoek JA, Meindersma EP, Hopman MTE, Bellersen L, Verbeek ALM, et al. Absence of fitness improvement is associated with outcomes in heart failure patients. Med Sci Sports Exerc. 2017;50(2):196–203.

    Article  Google Scholar 

  16. Arem H, Moore SC, Patel A, Hartge P, Berrington de Gonzalez A, Visvanathan K, et al. Leisure time physical activity and mortality: a detailed pooled analysis of the dose-response relationship. JAMA Intern Med. 2015;175(6):959–67.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Keteyian SJ, Leifer ES, Houston-Miller N, Kraus WE, Brawner CA, O’Connor CM, et al. Relation between volume of exercise and clinical outcomes in patients with heart failure. J Am Coll Cardiol. 2012;60(19):1899–905.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Eijsvogels TM, Molossi S, Lee DC, Emery MS, Thompson PD. Exercise at the extremes: the amount of exercise to reduce cardiovascular events. J Am Coll Cardiol. 2016;67(3):316–29.

    Article  PubMed  Google Scholar 

  19. Vromen T, Kraal JJ, Kuiper J, Spee RF, Peek N, Kemps HM. The influence of training characteristics on the effect of aerobic exercise training in patients with chronic heart failure: a meta-regression analysis. Int J Cardiol. 2016;208(1):120–7.

    Article  PubMed  CAS  Google Scholar 

  20. Mezzani A, Hamm LF, Jones AM, McBride PE, Moholdt T, Stone JA, et al. Aerobic exercise intensity assessment and prescription in cardiac rehabilitation: a joint position statement of the European Association for Cardiovascular Prevention and Rehabilitation, the American Association of Cardiovascular and Pulmonary Rehabilitation and the Canadian Association of Cardiac Rehabilitation. Eur J Prev Cardiol. 2013;20(3):442–67.

    Article  PubMed  Google Scholar 

  21. Siscovick DS, Weiss NS, Fletcher RH, Lasky T. The incidence of primary cardiac arrest during vigorous exercise. N Engl J Med. 1984;311(14):874–7.

    Article  PubMed  CAS  Google Scholar 

  22. Ismail H, McFarlane JR, Nojoumian AH, Dieberg G, Smart NA. 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(6):514–22.

    Article  PubMed  Google Scholar 

  23. Ellingsen Ø, Halle M, Conraads V, Støylen A, Dalen H, Delagardelle C, et al. High-Intensity Interval Training in Patients With Heart Failure With Reduced Ejection Fraction. Clinical Perspective. Circulation 2017;135(9):839–49.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Giuliano C, Karahalios A, Neil C, Allen J, Levinger I. The effects of resistance training on muscle strength, quality of life and aerobic capacity in patients with chronic heart failure – a meta-analysis. Int J Cardiol. 2017;227(15):413–23.

    Article  PubMed  Google Scholar 

  25. Spruit MA, Eterman RM, Hellwig VA, Janssen PP, Wouters EF, Uszko-Lencer NH. Effects of moderate-to-high intensity resistance training in patients with chronic heart failure. Heart. 2009;95(17):1399–408.

    Article  PubMed  CAS  Google Scholar 

  26. Keteyian SJ, Squires RW, Ades PA, Thomas RJ. Incorporating patients with chronic heart failure into outpatient cardiac rehabilitation: practical recommendations for exercise and self-care counseling – a clinical review. J Cardiopulm Rehabil Prev. 2014;34(4):223–32.

    Article  PubMed  Google Scholar 

  27. Engen-Verheul M van, Vries H de, Kemps H, Kraaijenhagen R, Keizer N de, Peek N. Cardiac rehabilitation uptake and its determinants in the Netherlands. Eur J Prev Cardiol. 2013;20(2):349–56.

    Article  PubMed  Google Scholar 

  28. Piotrowicz E, Piepoli MF, Jaarsma T, Lambrinou E, Coats AJ, Schmid JP, et al. Telerehabilitation in heart failure patients: the evidence and the pitfalls. Int J Cardiol. 2016;220(1):408–13.

    Article  PubMed  Google Scholar 

  29. Hwang R, Bruning J, Morris NR, Mandrusiak A, Russell T. Home-based telerehabilitation is not inferior to a centre-based program in patients with chronic heart failure: a randomised trial. J Physiother. 2017;63(2):101–7.

    Article  PubMed  Google Scholar 

  30. Vromen T, Spee RF, Kraal JJ, Peek N, Engen-Verheul MM van, Kraaijenhagen RA, et al. Exercise training programs in Dutch cardiac rehabilitation centres. Neth Heart J. 2013;21(3):138–43.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  31. Hoeve N ter, Huisstede BM, Stam HJ, Domburg RT van, Sunamura M, Berg-Emons RJ van den. Does cardiac rehabilitation after an acute cardiac syndrome lead to changes in physical activity habits? Systematic review. Phys Ther. 2015;95(2):167–79.

    Article  PubMed  Google Scholar 

  32. Deka P, Pozehl B, Williams MA, Yates B. Adherence to recommended exercise guidelines in patients with heart failure. Heart Fail Rev. 2017;22(1):41–53.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Zwolle, Nederland

    Johan Aernout Snoek

Authors
  1. Johan Aernout Snoek
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Johan Aernout Snoek.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Snoek, J.A. Training als therapie voor patiënten met hartfalen. Bijblijven 34, 456–464 (2018). https://doi.org/10.1007/s12414-018-0325-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12414-018-0325-3

Search

Navigation