Joughin H M, Digenio A G, Daly L, Kgare E
Johannesburg Cardiac Rehabilitation Centre, Metro Health and Scientific Services, Johannesburg Metropolitan Council.
S Afr Med J. 1999 May;89(5):545-50.
To assess the physiological changes that take place in patients with coronary artery disease after 6 and 18 months of moderate-intensity endurance training.
Prospective non-randomised controlled study.
Johannesburg Cardiac Rehabilitation Centre, a community-based phase III cardiac rehabilitation programme.
The 93 patients who completed 18 months of training form the experimental or 'complier' group, while the 18 patients who discontinued the programme form the comparison or 'dropout' group.
Haemodynamic, electrocardiographic and metabolic measurements at rest and at submaximal and peak exercise levels on admission and after 6 and 18 months of endurance training.
Among the compliers several significant changes took place. Resting heart rate and blood pressure decreased at 6 months (P < 0.005). Submaximal heart rate, blood pressure, rate-pressure product and ventilation decreased at 6 months (P < 0.0001, P < 0.01, P < 0.001, P < 0.01 respectively), and the rate-pressure product decreased further at 18 months (P < 0.05). Ventilatory threshold increased at 6 months (P < 0.0001). Peak oxygen uptake, heart rate and ventilation increased at 6 months (P < 0.0001, P < 0.005 and P < 0.0001, respectively), with no further changes at 18 months. Treadmill time increased at 6 months and again at 18 months (P < 0.0001). The only significant change in the dropout group was an increase in ST-segment depression on the exercise ECG from 0.2 to 0.6 mm (P < 0.05).
The study confirms that cardiac rehabilitation is beneficial. Most changes occurred in the first 6 months, the longer period of 18 months serving mostly as reinforcement of these and other lifestyle changes.
评估冠状动脉疾病患者在进行6个月和18个月中等强度耐力训练后发生的生理变化。
前瞻性非随机对照研究。
约翰内斯堡心脏康复中心，一个基于社区的Ⅲ期心脏康复项目。
完成18个月训练的93名患者组成实验组或“依从组”，而中断该项目的18名患者组成对照组或“退出组”。
在入组时以及耐力训练6个月和18个月后，静息、次极量运动和峰值运动水平下的血流动力学、心电图和代谢指标。
在依从组中发生了一些显著变化。静息心率和血压在6个月时下降（P < 0.005）。次极量心率、血压、心率血压乘积和通气量在6个月时下降（分别为P < 0.0001、P < 0.01、P < 0.001、P < 0.01），心率血压乘积在18个月时进一步下降（P < 0.05）。通气阈值在6个月时升高（P < 0.0001）。峰值摄氧量、心率和通气量在6个月时增加（分别为P < 0.0001、P < 0.005和P < 0.0001），18个月时无进一步变化。跑步机运动时间在6个月时增加，18个月时再次增加（P < 0.0001）。退出组唯一的显著变化是运动心电图上ST段压低从0.2毫米增加到0.6毫米（P < 0.05）。
该研究证实心脏康复有益。大多数变化发生在最初的6个月，18个月的较长时间主要是对这些以及其他生活方式改变的强化。
