van Dixhoorn J, Duivenvoorden H J, Pool J
St. Joannes de Deo Hospital, Haarlem, The Netherlands.
J Am Coll Cardiol. 1990 Apr;15(5):974-82. doi: 10.1016/0735-1097(90)90227-g.
One hundred fifty-six patients underwent a 5 week daily exercise training program after recovery from acute myocardial infarction. Outcome was assessed on the basis of exercise testing, integrating the measurements into a single outcome measure consisting of three categories (positive, n = 79; negative, n = 42; no change, n = 35). This composite criterion served as the end point for determining the predictability of a positive (training success) and negative (training failure) outcome. With use of logistic regression analysis, the baseline variables of clinical information, exercise data and psychosocial variables were able to identify patients with training success, as well as patients with failure (correct classification rates 81% and 85%, respectively). The characteristics of patients for whom training was beneficial differed from those of patients with a negative outcome. Work status before infarction was the single most important predictor of success, but it did not determine failure. Psychologic variables (type A behavior, well-being, depression) were important for predicting failure, but not for predicting success. Cardiac state and physical fitness largely determined training success. It is concluded that the physical benefit of exercise training in patients after myocardial infarction is highly predictable. Validation will make it possible to optimally apply exercise training as a therapeutic modality in these patients.
156例急性心肌梗死后康复的患者接受了为期5周的每日运动训练计划。基于运动测试评估结果，将各项测量结果整合为一个单一的结果指标，该指标分为三类（阳性，n = 79；阴性，n = 42；无变化，n = 35）。这个综合标准作为确定阳性（训练成功）和阴性（训练失败）结果可预测性的终点。使用逻辑回归分析，临床信息、运动数据和心理社会变量的基线变量能够识别训练成功的患者以及训练失败的患者（正确分类率分别为81%和85%）。训练有益的患者特征与阴性结果患者的特征不同。梗死前的工作状态是成功的最重要单一预测因素，但它不能决定失败。心理变量（A型行为、幸福感、抑郁）对预测失败很重要，但对预测成功不重要。心脏状态和身体素质在很大程度上决定了训练成功。结论是，心肌梗死后患者运动训练的身体益处具有高度可预测性。验证将使在这些患者中最佳地应用运动训练作为一种治疗方式成为可能。
