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运动类型对急性冠状动脉综合征患者血流动力学反应及心脏事件的影响。

Effects of Exercise Type on Hemodynamic Responses and Cardiac Events in ACS Patients.

作者信息

Kim Chul, Kim Chul-Hyun, Jee Haemi, Lim Young-Joon, Kim Young-Joo

机构信息

Department of Rehabilitation Medicine, College of Medicine, Sanggye-Paik Hospital, Inje University, Republic of Korea.

Department of Sports Medicine, Soonchunhyang University, Republic of Korea.

出版信息

J Phys Ther Sci. 2014 Apr;26(4):609-14. doi: 10.1589/jpts.26.609. Epub 2014 Apr 23.

Abstract

[Purpose] This study investigated the effects of mid, and high exercise intensities on hemodynamic responses and cardiac events during two exercise types of treadmill exercise (TM) and cycle ergometer exercises (CE) in patients with acute coronary syndrome (ACS). [Subjects] Patients who had percutaneous coronary intervention (PCI) for ACS and were participating in cardiac rehabilitation program were included. [Methods] The patients were assessed for hemodynamic responses, cardiac events, and rate of perceived exertion (RPE) with target heart rates of 60% and 85% heart rate reserve (HRR) during TM and CE. [Results] Maximum systolic blood pressure (SBP), diastolic blood pressure (DBP), RPE, and rate pressure product (RPP) measured during CE were significantly higher than their values in TM at the same exercise intensities. The highest SBP was shown at 85% HRR during CE. SBPmax to SBPmax ratios obtained during the graded exercise test (GXT) showed that all %SBPmax were significantly greater in CE than in TM at the same exercise intensities. Out of 102 patients, cardiac events occurred in 8 at 85% HRR during CE, and 1 at 85% HRR during TM. Patients with cardiac events (CE-E) had significantly higher %SBP, %RPP, and RPE at 85% HRR than those without events (CE-NE) during CE. [Conclusion] Prescribing exercise based on the intensity obtained in a treadmill GXT may expose patients to cardiovascular complications such as higher RPP, higher exercise intensity, and cardiac events during CE.

摘要

[目的] 本研究调查了中等强度和高强度运动对急性冠状动脉综合征(ACS)患者在两种运动类型(跑步机运动(TM)和自行车测力计运动(CE))过程中的血流动力学反应和心脏事件的影响。[对象] 纳入因ACS接受经皮冠状动脉介入治疗(PCI)并参加心脏康复计划的患者。[方法] 在TM和CE过程中,以心率储备(HRR)的60%和85%为目标心率,评估患者的血流动力学反应、心脏事件和主观用力程度(RPE)。[结果] 在相同运动强度下,CE过程中测得的最大收缩压(SBP)、舒张压(DBP)、RPE和心率血压乘积(RPP)显著高于TM过程中的相应值。CE过程中,最高SBP出现在85%HRR时。分级运动试验(GXT)期间获得的SBPmax与SBPmax比值显示,在相同运动强度下,CE的所有%SBPmax均显著高于TM。在102例患者中,CE过程中85%HRR时有8例发生心脏事件,TM过程中85%HRR时有1例发生心脏事件。在CE过程中,发生心脏事件的患者(CE-E)在85%HRR时的%SBP、%RPP和RPE显著高于未发生事件的患者(CE-NE)。[结论] 根据跑步机GXT获得的强度规定运动,可能会使患者在CE过程中面临心血管并发症,如更高的RPP、更高的运动强度和心脏事件。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3bb9/3996432/edabc3998b0b/jpts-26-609-g001.jpg

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