Nichtmedikamentöse Therapie der Herzinsuffizienz: Zur Rolle strukturierter Trainingsprogramme

Kernaussagen

Innerhalb der letzten 15 Jahre hat sich körperliches Ausdauertraining von einer kontrovers diskutierten symptomatisch orientierten Begleitbehandlung zu einer etablierten leitlinienorientierten adjuvanten Therapiestrategie entwickelt, die auf die Belastungstoleranz, CHI-Progression und wahrscheinlich auch die CHI-Mortalität dokumentierte positive Effekte hat.

Wichtigste Wirkungsmechanismen von Ausdauertraining bei CHI sind:

• Verbesserung der Endothelfunktion mit Abnahme des peripheren Widerstandes,

• Verbesserung der kardialen Funktion durch die damit verbundene Nachlastsenkung,

• Reduktion von oxidativem Stress und lokaler Inflammation im Skelettmuskel,

• Verbesserung des oxidativen Skelettmuskelmetabolismus,

• Umkehr der krankheitsbedingten Muskelatrophie und des Muskelkatabolismus.

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