Caminiti Giuseppe, Ranghi Francesca, De Benedetti Sara, Battaglia Daniela, Arisi Arianna, Franchini Alessio, Facchini Fabiana, Cioffi Veronica, Volterrani Maurizio
Cardiovascular Research Unit, Department of Medical Sciences, IRCCS San Raffaele, Via della Pisana 235, 00163 Rome, Italy.
Rehabil Res Pract. 2012;2012:218928. doi: 10.1155/2012/218928. Epub 2012 Dec 30.
Purpose. To determine whether the presence of cognitive impairment (CI) affects physical recovery of patients with chronic heart failure (CHF) undergoing a cardiac rehabilitation program (CRP). Methods. We enrolled 80 CHF patients (M/F = 53/27). CI was evaluated by means of the Mini-Mental State Examination (MMSE), exercise tolerance was evaluated by six-minute walking test (6 mwt). All patients underwent a 6-week CRP program at 50-70% of maximal V(O2). Patients were divided into two groups according to their MMSE (group 1: 16-23; group 2: 24-30). Results. MMSE resulted directly related to ejection fraction (r = 0.42; P = 0.03), and it was inversely related to creatinine (r = -0.36; P = 0.04). At 6 week group 1 had a lower increase in distance walked at 6 MWT than group 2 (P = 0.008). At multivariate logistic regression MMSE 16-23 predicted a reduced exercise recovery in the overall population (OR = 1.84; 95% CI = 1.50-2.18) and in women (OR = 1.42; 95% CI = 1.22-1.75), while it was not predicted in males. Conclusions. CI is a marker of advanced CHF and is an independent predictor of lower exercise recovery after CRP.
目的。确定认知障碍（CI）的存在是否会影响接受心脏康复计划（CRP）的慢性心力衰竭（CHF）患者的身体恢复情况。方法。我们纳入了80例CHF患者（男/女 = 53/27）。通过简易精神状态检查表（MMSE）评估CI，通过六分钟步行试验（6MWT）评估运动耐量。所有患者均在最大摄氧量的50 - 70% 水平下接受为期6周的CRP计划。根据MMSE将患者分为两组（第1组：16 - 23分；第2组：24 - 30分）。结果。MMSE与射血分数直接相关（r = 0.42；P = 0.03），与肌酐呈负相关（r = -0.36；P = 0.04）。在第6周时，第1组在6MWT中步行距离的增加低于第2组（P = 0.008）。在多因素逻辑回归分析中，MMSE评分为16 - 23分预测总体人群（比值比[OR] = 1.84；95%置信区间[CI] = 1.50 - 2.18）以及女性（OR = 1.42；95%CI = 1.22 - 1.75）运动恢复降低，而男性中未观察到这种预测关系。结论。CI是晚期CHF的一个标志物，并且是CRP后运动恢复降低的独立预测因素。
