Fattirolli Francesco, Burgisser Costanza, Guarducci Lorenzo, Rinaldi Lucio A, Masotti Giulio, Marchionni Niccolò
Dipartimento di Area Critica Medico-Chirurgica, S.O.D. di Cardiologia Geriatrica, A.O. Universitaria Careggi, Centro Regionale di Riferimento per la Riabilitazione Cardiologica, Università degli Studi, Firenze.
Ital Heart J Suppl. 2005 Dec;6(12):788-95.
Cardiac rehabilitation is an integral component of secondary prevention, and is indicated for patients with a wide variety of cardiac conditions, ranging from coronary artery disease to chronic heart failure. Best results are obtained with integrated, multicomponent cardiac rehabilitation programs, which include exercise training together with counseling and psychosocial measures that may help patients maintain sustained changes toward a more healthy lifestyle. Evidence from randomized controlled trials and meta-analyses supports the efficacy of cardiac rehabilitation on clinically relevant outcomes such as reduced long-term morbidity and mortality, enhanced functional profile and improved control of cardiovascular risk factors. However, the vast majority of this evidence derives from trials with only small numbers of patients > 70 years of age. In elderly patients the goal of cardiac rehabilitation may differ from those of younger patients, and include the preservation of mobility, self-sufficiency and mental function. Cardiac rehabilitation my represent an opportunity to provide effective health care and achieve a high quality of life for older patients. Future research programs should therefore be aimed at specifically investigating the efficacy and effectiveness of cardiac rehabilitation in older, frail cardiac patients.
心脏康复是二级预防的一个重要组成部分，适用于患有各种心脏疾病的患者，从冠状动脉疾病到慢性心力衰竭。采用综合的多成分心脏康复计划可获得最佳效果，这些计划包括运动训练以及咨询和心理社会措施，这些措施可能有助于患者朝着更健康的生活方式保持持续的改变。随机对照试验和荟萃分析的证据支持心脏康复对临床相关结局的疗效，如降低长期发病率和死亡率、改善功能状况以及更好地控制心血管危险因素。然而，绝大多数此类证据来自仅纳入少量70岁以上患者的试验。在老年患者中，心脏康复的目标可能与年轻患者不同，包括保持活动能力、自给自足和心理功能。心脏康复可能为老年患者提供有效的医疗保健并实现高质量生活提供了一个机会。因此，未来的研究计划应专门针对调查心脏康复在老年体弱心脏病患者中的疗效和有效性。
