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有氧运动间歇训练对冠心病患者有效性的随机临床试验的原理和设计:SAINTEX-CAD 研究。

Rationale and design of a randomized trial on the effectiveness of aerobic interval training in patients with coronary artery disease: the SAINTEX-CAD study.

机构信息

Department of Cardiology, Antwerp University Hospital, Edegem, Belgium; University of Antwerp, Antwerp, Belgium.

出版信息

Int J Cardiol. 2013 Oct 9;168(4):3532-6. doi: 10.1016/j.ijcard.2013.05.007. Epub 2013 May 24.

Abstract

BACKGROUND

Exercise-based cardiac rehabilitation is considered an important adjunct treatment and secondary prevention measure in patients with coronary artery disease (CAD). However, the issues of training modality and exercise intensity for CAD patients remain controversial.

OBJECTIVE

Main aim of the present study is to test the hypothesis that aerobic interval training (AIT) yields a larger gain in peak aerobic capacity (peakVO2) compared to a similar training programme of moderate continuous training (MCT) in CAD patients.

STUDY DESIGN

In this multicentre study stable CAD patients with left ventricular ejection fraction>40% will be randomized after recent myocardial infarction or revascularization (PCI or CABG) to a supervised 12-week programme of three weekly sessions of either AIT (85-90% of peak oxygen uptake [peakVO2], 90-95% of peak heart rate) or MCT (60-70% of peakVO2, 65-75% of peak heart rate). The primary endpoint of the study is the change of peakVO2 after 12 weeks training. Secondary endpoints include safety, changes in peripheral endothelial vascular function, the evolution of traditional cardiovascular risk factors, quality of life and the number and function of circulating endothelial progenitor cells as well as endothelial microparticles. Possible differences in terms of long-term adherence to prescribed exercise regimens will be assessed by regular physical activity questionnaires, accelerometry and reassessment of peakVO2 12 months after randomization. A total number of 200 patients will be randomized in a 1:1 manner (significance level of 0.05 and statistical power of 0.90). Enrolment started December 2010; last enrolment is expected for February 2013.

摘要

背景

运动为基础的心脏康复被认为是冠心病(CAD)患者的重要辅助治疗和二级预防措施。然而,CAD 患者的训练方式和运动强度问题仍存在争议。

目的

本研究的主要目的是检验以下假设,即与类似的中等持续训练(MCT)方案相比,有氧运动间歇训练(AIT)可使 CAD 患者的峰值有氧能力(peakVO2)获得更大的提高。

研究设计

在这项多中心研究中,将稳定的 CAD 患者(左心室射血分数>40%)随机分组,在近期心肌梗死后或血运重建(PCI 或 CABG)后,接受 12 周的监督治疗,每周 3 次,分别为 AIT(峰值摄氧量[peakVO2]的 85-90%,峰值心率的 90-95%)或 MCT(peakVO2 的 60-70%,峰值心率的 65-75%)。研究的主要终点是 12 周训练后 peakVO2 的变化。次要终点包括安全性、外周内皮血管功能的变化、传统心血管危险因素的演变、生活质量以及循环内皮祖细胞和内皮微颗粒的数量和功能。通过定期的身体活动问卷、加速度计和随机分组后 12 个月重新评估 peakVO2,评估长期坚持规定运动方案的差异。将以 1:1 的比例随机分配 200 名患者(显著性水平为 0.05,统计效力为 0.90)。招募于 2010 年 12 月开始;预计最后一次招募将于 2013 年 2 月结束。

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