Jessa Hospital, Rehabilitation and Health Centre, Heart Centre Hasselt, Hasselt and Vrije Universiteit Brussel, Department of Human Physiology and Sportsmedicine, Brussels, Belgium.
Clin Rehabil. 2010 Apr;24(4):319-27. doi: 10.1177/0269215509353262. Epub 2010 Feb 22.
To assess whether exercise volume during phase II rehabilitation affects long-term clinical benefits in patients with coronary artery disease.
Prospective randomized clinical trial with long-term follow-up.
Hospital outpatient clinic.
Coronary artery disease patients (age 65 +/- 9 years, 82% males) attending a phase II rehabilitation programme were randomized into two groups of exercise volumes: 40- versus 60-minute training sessions. Patients exercised for three days per week for seven weeks, at 65% of baseline oxygen uptake capacity. Next, they were followed up for 18 months. Out of 165 patients with coronary artery disease who completed the exercise intervention, 119 attended the 18-month follow-up assessment.
Body anthropometrics, resting haemodynamics, blood lipid profile, glycaemia, and C-reactive protein level, smoking behaviour, habitual physical activity, cardiovascular disease incidence and mortality.
In total population, a significant worsening of various cardiovascular disease risk factors was found at 18 months follow-up (P<0.05), and few patients (27% of total group) adhered to the recommended minimal physical activity level. No difference in change of body anthropometrics, resting haemodynamics, blood lipid profile, glycaemia, and C-reactive protein level, and smoking behaviour was seen between different exercise volumes (P>0.05). In addition, total cardiovascular disease incidence (13% versus 22% in 40- versus 60-minute group, respectively) and habitual physical activity were not different between groups (P>0.05).
In patients with coronary artery disease following cardiac rehabilitation, the cardiovascular disease risk profile worsened significantly during long-term follow-up. A smaller exercise volume during phase II rehabilitation generated equal long-term clinical benefits compared to a greater exercise volume.
评估冠心病患者二期康复阶段的运动总量对长期临床获益的影响。
前瞻性随机临床试验，长期随访。
医院门诊。
参加二期康复项目的冠心病患者（年龄 65±9 岁，82%为男性），按运动总量随机分为两组：40 分钟组和 60 分钟组。患者每周运动 3 天，强度为基础摄氧量的 65%，共持续 7 周。然后进行 18 个月的随访。165 例完成运动干预的冠心病患者中，119 例参加了 18 个月的随访评估。
人体测量学指标、静息血流动力学、血脂谱、血糖和 C 反应蛋白水平、吸烟行为、习惯性体力活动、心血管疾病发生率和死亡率。
总体人群在 18 个月随访时发现各种心血管疾病危险因素显著恶化（P<0.05），仅有少数患者（总组的 27%）达到推荐的最低体力活动水平。不同运动总量组之间的人体测量学指标、静息血流动力学、血脂谱、血糖和 C 反应蛋白水平以及吸烟行为的变化无差异（P>0.05）。此外，两组之间的总心血管疾病发生率（40 分钟组为 13%，60 分钟组为 22%）和习惯性体力活动无差异（P>0.05）。
在冠心病患者心脏康复后，长期随访期间心血管疾病风险谱显著恶化。二期康复阶段运动总量较少与较多相比，产生了同等的长期临床获益。
