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运动为基础的心脏康复对动脉僵硬度及炎症和内皮功能障碍生物标志物的影响:心肌梗死患者的随机对照试验。

Effect of exercise-based cardiac rehabilitation on arterial stiffness and inflammatory and endothelial dysfunction biomarkers: a randomized controlled trial of myocardial infarction patients.

机构信息

Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200.450 Porto, Portugal.

School of Health Sciences, University of Aveiro, Agras do Crasto, Campus Universitário de Santiago, 3810.193 Aveiro, Portugal.

出版信息

Atherosclerosis. 2015 Mar;239(1):150-7. doi: 10.1016/j.atherosclerosis.2014.12.057. Epub 2015 Jan 14.

Abstract

BACKGROUND

Arterial stiffness have shown an independent predictive value for cardiovascular and all-cause mortality.

OBJECTIVE

This study sought to evaluate the effects of an 8-week exercise-based cardiac rehabilitation program (ECR) on arterial stiffness, and on inflammatory and endothelial dysfunction biomarkers. Additionally, it was assessed two potential confounding variables, daily physical activity and dietary intake.

METHODS

In this parallel-group trial, 96 patients (56 ± 10 years) were randomized to either the exercise group (EG) or control group (CG) 4 weeks after suffering acute myocardial infarction (MI). ECR consisted of 8 weeks of aerobic exercise at 70-85% of maximal heart rate during 3 sessions weekly, plus usual care. CG participants received only usual care. Baseline and final assessments included arterial stiffness through carotid-femoral pulse wave velocity (cf-PWV), inflammatory and endothelial dysfunction biomarkers, daily physical activity, and dietary intake. (ClinicalTrials.gov: NCT01432639).

RESULTS

After 8 weeks, no significant changes were found between groups in cf-PWV, inflammatory and endothelial dysfunction biomarkers, daily physical activity, or dietary intake. Excluding those patients (n = 7) who did not attend, at least 80% of the exercise sessions provided similar results, excepting a significant reduction in cf-PWV in the EG compared to the CG.

CONCLUSIONS

A short-term ECR does not seem to reduce arterial stiffness and inflammatory and endothelial dysfunction biomarkers of post-MI patients under optimized medication. Nevertheless, the decrease of cf-PWV observed in the EG, when considering only those patients who attended at least 80% of exercise sessions, warrants further investigation.

摘要

背景

动脉僵硬度已显示出对心血管和全因死亡率的独立预测价值。

目的

本研究旨在评估 8 周基于运动的心脏康复计划(ECR)对动脉僵硬度以及炎症和内皮功能障碍生物标志物的影响。此外,还评估了两个潜在的混杂变量,即日常体力活动和饮食摄入。

方法

在这项平行组试验中,96 名患者(56±10 岁)在急性心肌梗死(MI)后 4 周被随机分配到运动组(EG)或对照组(CG)。ECR 包括 8 周的有氧运动,在最大心率的 70-85%下每周进行 3 次,加上常规护理。CG 组仅接受常规护理。基线和最终评估包括通过颈股脉搏波速度(cf-PWV)评估动脉僵硬度、炎症和内皮功能障碍生物标志物、日常体力活动和饮食摄入。(ClinicalTrials.gov:NCT01432639)。

结果

8 周后,cf-PWV、炎症和内皮功能障碍生物标志物、日常体力活动或饮食摄入在两组之间均无显著变化。排除未参加至少 80%运动课程的 7 名患者(n=7)后,结果相似,除了 EG 组的 cf-PWV 显著降低与 CG 相比。

结论

在优化药物治疗的情况下,短期 ECR 似乎不会降低 MI 后患者的动脉僵硬度和炎症及内皮功能障碍生物标志物。然而,当仅考虑参加至少 80%运动课程的患者时,EG 观察到的 cf-PWV 降低值得进一步研究。

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