Zusammenfassung
Regelmäßiges körperliches Training führt sowohl bei Herzgesunden als auch bei Patienten mit koronarer Herzkrankheit innerhalb weniger Wochen zu einer deutlichen Steigerung der körperlichen Leistungsfähigkeit [21]. Lange Zeit war umstritten, ob diese positiven Trainingseffekte auch bei Patienten mit hochgradig eingeschränkter linksventrikulärer Pumpfunktion ohne Erhöhung des individuellen Risikos reproduzierbar sind. Entgegen aller Skepsis wurde inzwischen in zahlreichen randomisierten Trainingsstudien eine homogene Verbesserung der funktionellen Leistungsfähigkeit (gemessen an der maximalen Sauerstoffaufnahme) um durchschnittlich 2 ml/kg · min dokumentiert [20] (Tabelle 1). Körperliches Training ist im Gegensatz zu den meisten pharmakologischen Interventionen jedoch weder eine organ- noch eine rezeptorspezifische Therapie. Durch körperliches Training werden verschiedene funktionelle Systeme beeinflusst:
-
1.
Skelettmuskelmetabolismus und -funktion
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2.
Endothelfunktion
-
3.
neurohumorales System und
-
4.
zentrale Hämodynamik.
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Hambrecht, R. (2001). Schwere chronische Herzinsuffizienz — Möglichkeiten und Grenzen der körperlichen Belastung. In: Rauch, B., Held, K. (eds) Der schwerkranke und multimorbide Herzpatient. Steinkopff. https://doi.org/10.1007/978-3-642-93723-1_9
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