Tegtbur U, Busse M W, Jung K, Markofsky A, Machold H, Brinkmeier U, Künsebeck H W, Haverich A, Pethig K
Medizinische Hochschule Hannover, Sportmedizinisches Zentrum (OE 4252), Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
Z Kardiol. 2003 Nov;92(11):908-15. doi: 10.1007/s00392-003-0968-6.
Longterm treatment after heart transplantation (HTX) improves survival, although the quality of life and exercise tolerance decreased continuously between one and ten years after transplantation. The role of physical exercise and psychological support in longterm treatment after HTX has not been determined. We analyzed the effects of a one year outpatient rehabilitation program in combination with a home based, computer assisted training program on exercise capacity, coronary risk factors and quality of life.
20 heart transplant recipients in an intervention group and 12 patients after HTX in a control group participated in the study (IG (CG); 5.1+/-2.2 (4.5+/-2.3) years after HTX; age: 55+/-7 (54+/-8) years; body mass index: 28.3+/-1.0 (28.7+/-0.9) kg.m(-2)). Before and after the intervention, maximum and constant load exercise capacity, and self-reported quality of life were evaluated. The 12 month intervention period included 10 days of exercise testing as well as medical and psychological support. Furthermore, the IG group performed a computer-assisted and controlled home ergometer training every second day.
After one year with 114+/-18 exercise training sessions, maximum oxygen consumption increased in the IG from 18.8+/-4.2 to 20.1+/-4.2 ml.min(-1).kg(-1) (p<0.05; CG 19.3+/- 4.5 to 18.5+/-2.8 ml.min(- 1).kg(-1); p<0.01 IG vs CG). In the IG, lower back pain, body fat, and blood pressure were all reduced, while the self-reported quality of life, endurance exercise capacity and HDL cholesterol were increased. No significant changes occurred in the control group.
When initiated years after heart transplantation, longterm rehabilitation reduced coronary risk factors and significantly improved both the subjects' quality of life, as well as a near to normal capacity for physical work.
心脏移植（HTX）后的长期治疗可提高生存率，尽管移植后1至10年间生活质量和运动耐量持续下降。体育锻炼和心理支持在HTX后长期治疗中的作用尚未确定。我们分析了一项为期一年的门诊康复计划与一项基于家庭的计算机辅助训练计划相结合对运动能力、冠心病危险因素和生活质量的影响。
干预组的20名心脏移植受者和对照组的12名HTX后患者参与了研究（IG（CG）；HTX后5.1±2.2（4.5±2.3）年；年龄：55±7（54±8）岁；体重指数：28.3±1.0（28.7±0.9）kg·m⁻²）。在干预前后，评估了最大和恒定负荷运动能力以及自我报告的生活质量。为期12个月的干预期包括10天的运动测试以及医疗和心理支持。此外，IG组每隔一天进行一次计算机辅助的家庭测力计训练。
经过一年114±18次运动训练后，IG组的最大耗氧量从18.8±4.2增加到20.1±4.2 ml·min⁻¹·kg⁻¹（p<0.05；CG组从19.3±4.5降至18.5±2.8 ml·min⁻¹·kg⁻¹；IG组与CG组比较，p<0.01）。在IG组中，下背痛、体脂和血压均降低，而自我报告的生活质量、耐力运动能力和高密度脂蛋白胆固醇增加。对照组未发生显著变化。
在心脏移植多年后开始进行长期康复治疗，可降低冠心病危险因素，并显著改善受试者的生活质量以及接近正常的体力工作能力。
