Department of Cardiac Rehabilitation and Noninvasive Electrocardiology, Institute of Cardiology, Alpejska 42, Warsaw 04-628, Poland.
Eur J Heart Fail. 2010 Feb;12(2):164-71. doi: 10.1093/eurjhf/hfp181. Epub 2009 Dec 30.
Despite proven benefits of cardiac rehabilitation (CR), currently proposed CR models are not acceptable for many heart failure (HF) patients. The purpose of this study was to evaluate a new model of home-based telemonitored cardiac rehabilitation (HTCR) using walking training compared with an outpatient-based standard cardiac rehabilitation (SCR) using interval training on a cycle ergometer.
The study included 152 HF patients (aged 58.1 + or - 10.2 years, NYHA class II and III, ejection fraction < or = 40%) who were randomized to HTCR (n = 77) or SCR (n = 75). All patients underwent 8 weeks of CR. Both groups were comparable in terms of demographic and clinical characteristics and medical therapy. The effectiveness of CR was assessed by changes in NYHA class, peak oxygen consumption, 6-min walking test distance, and SF-36 score. Cardiac rehabilitation resulted in a significant improvement of all parameters in both groups. All patients in the HTCR group completed the 8 weeks of CR, whereas 15 patients in the SCR group (20%) discontinued CR.
In patients with HF, HTCR is equally as effective as SCR and provides a similar improvement in quality of life. Adherence to CR seems to be better for HTCR. Home-based telemonitored cardiac rehabilitation may be a useful alternative form of CR in patients with HF.
尽管心脏康复（CR）已被证实有益，但目前提出的 CR 模式并不被许多心力衰竭（HF）患者所接受。本研究旨在评估一种新的家庭为基础的远程监测心脏康复（HTCR）模式，该模式使用步行训练，并与基于门诊的标准心脏康复（SCR）模式进行比较，后者使用踏车进行间歇训练。
该研究纳入了 152 例 HF 患者（年龄 58.1 ± 10.2 岁，NYHA 心功能 II 级和 III 级，射血分数≤40%），随机分为 HTCR 组（n = 77）或 SCR 组（n = 75）。所有患者均接受 8 周的 CR。两组在人口统计学和临床特征以及药物治疗方面具有可比性。CR 的有效性通过 NYHA 心功能分级、峰值耗氧量、6 分钟步行试验距离和 SF-36 评分的变化来评估。CR 使两组所有参数均显著改善。HTCR 组的所有患者均完成了 8 周的 CR，而 SCR 组有 15 例（20%）患者停止了 CR。
在 HF 患者中，HTCR 与 SCR 同样有效，可显著提高生活质量。HTCR 的 CR 依从性似乎更好。家庭为基础的远程监测心脏康复可能是 HF 患者的一种有用的 CR 替代形式。
