Bjarnason-Wehrens B, Bott D, Benesch L, Bischoff K O, Buran-Kilian B, Gysan D, Hollenstein U, Mayer-Berger W, Wilkniss R, Sauer G
Institute of Cardiology and Sports Medicine, German Sport University Cologne, Germany.
Clin Res Cardiol. 2007 Feb;96(2):77-85. doi: 10.1007/s00392-007-0461-0. Epub 2006 Dec 14.
The short-term benefits of cardiac rehabilitation (CR) are well established. In contrast, well-documented long-term results are rare. The objective of this longitudinal multi-centre observational study was to examine the effects of intensive out-patient CR in a larger patient cohort, especially for patients with low social status. We present the final results 24 months after CR.
The study group of 327 patients (288 men, 39 women, aged 56.0+/-10.8 years, coronary artery disease in 295, other cardiac diseases in 32) participated in a 3- week CR programme followed by clinical re-evaluations 6 (III), 12 (IV) an 24 (V) months later.
The improvement in mean maximal performance of 100.5+/-31.4 to 123.1+/-36.2 W (p<0.01) achieved during CR was further improved to 128.7+/-40.9 W (p < 0,01) after 24 months. Of the patients, 61.2% reported regular physical activity during the 24 months of the study. The lipid management achieved by CR was maintained over 24 month. At I 65%, at II 84.4% and at V 82.4% of the patients with coronary artery disease (CAD) were undergoing lipid lowering therapy. BMI increased from 26.8+/-3.0 to 27.6+/-3.6 kg/m2 (p < 0.01) during follow-up. Of the patients, 23.2% were active smokers at V. Cardiovascular diagnosis remained unaltered in 74.3% of patients. The obtained results are interesting with respect to the social status of the patients since 68% were general laborers. The results confirm the long-term effectiveness of an intensive 3-week out-patient CR programme. Most of the benefits achieved by CR appear to be sustainable in this population for at least 2 years.
心脏康复(CR)的短期益处已得到充分证实。相比之下,有充分记录的长期结果却很少见。这项纵向多中心观察性研究的目的是在更大的患者队列中研究强化门诊心脏康复的效果,尤其是对社会地位较低的患者。我们展示了心脏康复24个月后的最终结果。
327名患者(288名男性,39名女性,年龄56.0±10.8岁,295例患有冠状动脉疾病,32例患有其他心脏病)组成的研究组参加了为期3周的心脏康复计划,随后在6个月(III)、12个月(IV)和24个月(V)后进行临床重新评估。
心脏康复期间平均最大运动能力从100.5±31.4瓦提高到123.1±36.2瓦(p<0.01),24个月后进一步提高到128.7±40.9瓦(p<0.01)。在研究的24个月中,61.2%的患者报告有规律的体育活动。心脏康复实现的血脂管理在24个月内得以维持。在I期,65%的冠状动脉疾病(CAD)患者接受降脂治疗;在II期,这一比例为84.4%;在V期,为82.4%。随访期间,体重指数从26.8±3.0增加到27.6±3.6kg/m²(p<0.01)。在V期,23.2%的患者仍为活跃吸烟者。74.3%的患者心血管诊断未发生变化。考虑到患者的社会地位,所得结果很有意思,因为68%是普通劳动者。结果证实了为期3周的强化门诊心脏康复计划的长期有效性。在该人群中,心脏康复带来的大部分益处似乎至少可持续2年。