Clinical characteristic of non-responder to exercise therapy in chronic heart failure

2018 Fiscal Year Final Research Report

• Project/Area Number: 15K16367
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Rehabilitation science/Welfare engineering
• Research Institution: Dokkyo Medical University
• Principal Investigator: Ueno Asuka (栗原) 獨協医科大学, 医学部, 助教 (50725546)
• Research Collaborator: YASU takanori ; TAMURA yuuma
• Project Period (FY): 2015-04-01 – 2019-03-31
• Keywords: 心臓リハビリテーション / 運動耐容能 / T波オルタナンス(TWA) / 心拍変動解析 / 交感神経活性

Outline of Final Research Achievements

Aim is to explore the clinical characteristics of exercise non-responder in chronic heart failure. We defined exercise non-responder as less than 5% increase in peakVO2 after five-month cardiac rehabilitation program or cardiovascular events. Study subjects were 18 with chronic heart failure (non-responder, 8; responders, 10).　Non-responder showed lower quadriceps muscle extension after cardiac rehabilitation. There were no significant differences in T-wave alternans (TWA), intermediate frequency components / high frequency components (LF / HF) in Holter ECG. There was a positive correlation trend between initial peakVO2 and nighttime LF / HF. TWA positive was identified in only one patient, and the statistical evaluation regarding TWA was not undergone.

Free Research Field

心臓リハビリテーション

Academic Significance and Societal Importance of the Research Achievements

本研究の意義は、第一に慢性心不全患者において運動療法の効果を阻害する背景因子を明らかにし、効果的な個別化リハビリテーション介入プログラムに貢献すること。第二に、突然死や交感神経活性との関連を調べ、予後改善のためのevidenceを構築することである。
今回、エントリー数と解析可能な患者数がともに少なく、統計学的評価が不十分な部分があったため、プロトコールと患者登録・追跡方法の再検討を加え、本研究を継続することにより上記の意義を達する計画である。