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基于运动的心脏康复可改善冠状动脉搭桥手术后的血流动力学反应。

Exercise-based cardiac rehabilitation improves hemodynamic responses after coronary artery bypass graft surgery.

作者信息

Ghashghaei Fatemeh Esteki, Sadeghi Masoumeh, Marandi Seyed Mohammad, Ghashghaei Samira Esteki

机构信息

MSc, Department of Physical Educational and Sport Sciences, Khorasgan Branch, Islamic Azad University, Isfahan, Iran.

出版信息

ARYA Atheroscler. 2012 Winter;7(4):151-6.

Abstract

BACKGROUND

Cardiovascular disorders are an important public health problem worldwide. They are also the leading cause of mortality and morbidity. Therefore, American Heart Association proposed cardiac rehabilitation program as an essential part of care for cardiac patients to improve functional capacity. The aim of this study was to evaluate the effectiveness of cardiac rehabilitation program on functional status and some hemodynamic responses in patients after coronary artery bypass graft (CABG) surgery.

METHODS

Thirty two patients were selected for this study. All patients underwent cardiac surgery two months before admission. They were allocated to two groups. While the rehabilitation group (n =17, mean age: 62 ± 12 years) completed the cardiac rehabilitation program for two months, the reference group (n = 15, mean age: 58.5 ± 12.5 years) did not have any supervised physical activity during this period. Cardiac rehabilitation program consisted of exercise, nutritional, psychological consultation and risk factor management. At the beginning of the study, functional capacity of patients was evaluated by exercise test, 6-minute walking test and echocardiography. Functional capacity was evaluated for a second time after two months of cardiac rehabilitation. Data were analyzed by SPSS(15). For comparing the mean of outcomes, Mann-Whitney test and Wilcoxon signed ranks test were used.

RESULTS

As a result of cardiac rehabilitation, a significant improvement was observed in the distance walked in the rehabilitation group (P < 0.01) compared to the reference group (P = 0.33). It also caused a significant development in hemodynamic responses to exercise such as resting and maximum systolic and diastolic blood pressure, resting and maximum heart rate, ejection fraction and rate pressure product.

CONCLUSION

Cardiac rehabilitation significantly improves functional capacity and some hemodynamic responses post coronary artery bypass grafting. Therefore, patients need to be referred to rehabilitation units.

摘要

背景

心血管疾病是全球重要的公共卫生问题。它们也是死亡率和发病率的主要原因。因此,美国心脏协会提出心脏康复计划作为心脏病患者护理的重要组成部分,以提高功能能力。本研究的目的是评估心脏康复计划对冠状动脉旁路移植术(CABG)后患者功能状态和一些血流动力学反应的有效性。

方法

本研究选取了32例患者。所有患者在入院前两个月接受了心脏手术。他们被分为两组。康复组(n = 17,平均年龄:62±12岁)完成了为期两个月的心脏康复计划,而参照组(n = 15,平均年龄:58.5±12.5岁)在此期间没有任何有监督的体育活动。心脏康复计划包括运动、营养、心理咨询和危险因素管理。在研究开始时,通过运动试验、6分钟步行试验和超声心动图评估患者的功能能力。在心脏康复两个月后第二次评估功能能力。数据用SPSS(15)进行分析。为比较结果的均值,使用了曼-惠特尼检验和威尔科克森符号秩检验。

结果

心脏康复的结果显示,与参照组(P = 0.33)相比,康复组的步行距离有显著改善(P < 0.01)。它还使运动时的血流动力学反应有显著改善,如静息和最大收缩压及舒张压、静息和最大心率、射血分数和心率血压乘积。

结论

心脏康复显著改善冠状动脉旁路移植术后的功能能力和一些血流动力学反应。因此,需要将患者转至康复单元。

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