Ueda Takashi, Miura Shin-Ichiro, Fujimi Kanta, Ishida Toshihisa, Matsuda Takuro, Fujita Masaomi, Ura Yoshiyuki, Kaino Kouji, Sakamoto Maya, Horita Tomoe, Arimura Tadaaki, Shiga Yuhei, Kuwano Takashi, Kitajima Ken, Saku Keijiro
Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan.
Department of Molecular Cardiovascular Therapeutics, Fukuoka University School of Medicine, Fukuoka, Japan.
Int J Cardiol Heart Vasc. 2016 Aug 1;12:63-67. doi: 10.1016/j.ijcha.2016.07.004. eCollection 2016 Sep.
Cardiac rehabilitation (CR) improves cardiac function and exercise capacity in patients with cardiovascular disease (CVD). Simpler techniques are needed for use by physicians in the examination room to assess the usefulness of CR. We enrolled 46 consecutive CVD patients in a CR program (CR group) and prospectively followed them for 3 months. We compared them to 18 age-, gender- and body mass index-matched CVD patients without CR (non-CR group). Various parameters were measured at baseline and after 3 months using 3 simple non-invasive tests: severity of atherosclerosis [arterial velocity pulse index and arterial pressure volume index (API)] were determined using PASESA®, an autonomic nerve total activity amount index and a coefficient of variation of the R-R interval (CVRR) were determined using eHEART®, and peripheral resistance index, pressure rate product, stroke volume and cardiac index were determined using nico®]. There were no significant differences in patient characteristics including percentages (%) of ischemic heart disease and heart failure between the non-CR and CR groups. Systolic blood pressure (SBP), diastolic BP, heart rate and API at baseline significantly decreased and CVRR at baseline significantly increased after 3 months in the CR group, but not in the non-CR group. In addition, ΔAPI (Δ = the value after 3 months minus the value at baseline) was positively associated with ΔSBP in the CR group. In conclusion, CR significantly decreased BP and improved atherosclerosis and sympathetic nerve activity. These findings suggest that simple non-invasive tests may be useful for assessing the effects of CR.
心脏康复(CR)可改善心血管疾病(CVD)患者的心脏功能和运动能力。医生在检查室需要更简单的技术来评估CR的效用。我们将46例连续的CVD患者纳入CR项目(CR组),并对他们进行了为期3个月的前瞻性随访。我们将他们与18例年龄、性别和体重指数相匹配但未接受CR的CVD患者(非CR组)进行比较。在基线和3个月后,使用3种简单的非侵入性测试测量了各种参数:使用PASESA®测定动脉粥样硬化的严重程度[动脉速度脉搏指数和动脉压力容积指数(API)],使用eHEART®测定自主神经总活动量指数和R-R间期变异系数(CVRR),使用nico®测定外周阻力指数、压力率乘积、每搏输出量和心脏指数。非CR组和CR组之间在包括缺血性心脏病和心力衰竭百分比(%)在内的患者特征方面没有显著差异。CR组在3个月后,基线时的收缩压(SBP)、舒张压、心率和API显著降低,基线时的CVRR显著升高,而非CR组则无此变化。此外,CR组中ΔAPI(Δ=3个月后的数值减去基线时的数值)与ΔSBP呈正相关。总之,CR显著降低了血压,改善了动脉粥样硬化和交感神经活动。这些发现表明,简单的非侵入性测试可能有助于评估CR的效果。