Körperliches Training in der Sekundärprävention kardiovaskulärer Erkrankungen – sind die Guidelines noch aktuell?

Zusammenfassung

Körperliches Training ist fester Bestandteil der leitliniengerechten Therapie kardiovaskulärer Erkrankungen. Dabei hat ein kombiniertes Ausdauer- und Krafttraining positive Effekte auf körperliche Belastbarkeit, Lebensqualität und Prognose. Das Ausdauertraining beschränkt sich bisher weitgehend auf moderate Intensitäten, obwohl es Hinweise gibt, dass ein Intervalltraining mit vergleichbaren bis sogar besseren Ergebnissen verbunden ist. Studien deuten u. a. darauf hin, dass Intervalltraining bei Patienten mit Herzinsuffizienz nicht nur zu einer effektiveren Leistungssteigerung, sondern auch zu günstigen strukturellen und funktionellen kardialen Veränderungen führt. Bei metabolischem Syndrom scheint durch Intervalltraining ein noch günstigerer Effekt auf den Stoffwechsel, z. B. durch Erhöhung der Insulinsensitivität, induziert zu werden. Bevor ein genereller Umbruch von moderatem Training zu Intervalltraining durchgeführt werden sollte, bedarf es allerdings noch deutlich umfassenderer Evidenz. Zum aktuellen Zeitpunkt sollte ein Einsatz von Intervalltraining im klinischen Alltag noch eher zurückhaltend und nach klinischer Abwägung erfolgen.

Abstract

Physical training is an inherent part of guideline-based therapy of cardiovascular diseases. Combined endurance and resistance training has positive effects on exercise capacity, quality of life and prognosis. Endurance training has so far been limited to moderate intensities, although there is evidence that interval training has comparable or even better results. Studies indicate that interval training in heart-failure-patients induces more effective increase in exercise performance, but moreover also yields favorable structural and functional cardiac changes. Interval training in metabolic syndrome seems to induce even more favorable metabolic effects, e.g. by increasing insulin sensitivity. Before a general recommendation for interval training can be given, more comprehensive evidence is required. At present interval training in clinical practice can be applied after careful clinical assessment and in a supervised setting.

Schlüsselwörter

Prävention - kardiovaskuläre Erkrankungen - körperliches Training - Ausdauertraining - Intervalltraining

Key words

prevention - cardiovascular disease - exercise training - endurance training - interval training

• Literatur

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