Futami Makito, Fujimi Kanta, Ueda Takashi, Matsuda Takuro, Fujita Masaomi, Kaino Kouji, Sakamoto Maaya, Horita Tomoe, Koyoshi Rie, Arimura Tadaaki, Shiga Yuhei, Kuwano Takashi, Kitajima Ken, Saku Keijiro, Miura Shin-Ichiro
Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan.
Department of Rehabilitation, Fukuoka University Hospital, Fukuoka, Japan.
Int J Cardiol Heart Vasc. 2017 Oct 10;17:23-29. doi: 10.1016/j.ijcha.2017.10.001. eCollection 2017 Dec.
We evaluated whether comprehensive cardiac rehabilitation (CR) in patients with cardiovascular disease (CVD) could improve various hemodynamic parameters obtained using simple non-invasive tests. We analyzed 48 CVD patients with (n = 38, CR group) or without (n = 10, non-CR group) a CR program, and prospectively followed them for 12 months. Various parameters were measured at baseline and after 12 months using 3 simple non-invasive tests: blood pressure (BP) and severity of atherosclerosis [arterial velocity pulse index (AVI) and atrial pressure volume index] were determined using PASESA®, an index of total autonomic nerve activity and a coefficient of variation of the R-R interval (CVRR) were determined using eHEART®, and the total peripheral resistance, stroke volume and cardiac index (CI) were determined using nico®. The main hemodynamic parameters did not change between baseline and 12 months in both groups. Patients in the CR group were divided into higher (H-) and lower (L-) systolic BP (SBP) or AVI according to the average value of SBP or AVI at baseline in the CR group. Patients with H-SBP or H-AVI in the CR group showed a significant reduction of SBP or AVI at 12 months. In addition, patients in the CR group were divided into H- and L- CI or CVRR according to the average value of CI or CVRR at baseline in the CR group. Patients with L-CI or L-CVRR in the CR group significantly improved after 12 months. In conclusion, CR may lead various hemodynamic parameters obtained using simple non-invasive tests to their appropriate levels.
我们评估了心血管疾病(CVD)患者进行全面心脏康复(CR)是否能改善通过简单无创检查获得的各种血流动力学参数。我们分析了48例接受(n = 38,CR组)或未接受(n = 10,非CR组)CR计划的CVD患者,并对他们进行了为期12个月的前瞻性随访。在基线和12个月后使用3种简单无创检查测量了各种参数:使用PASESA®测定血压(BP)和动脉粥样硬化严重程度[动脉速度脉搏指数(AVI)和心房压力容积指数],使用eHEART®测定总自主神经活动指数和R-R间期变异系数(CVRR),使用nico®测定总外周阻力、每搏输出量和心脏指数(CI)。两组患者的主要血流动力学参数在基线和12个月之间均未发生变化。根据CR组基线时收缩压(SBP)或AVI的平均值,将CR组患者分为高(H-)和低(L-)SBP或AVI。CR组中H-SBP或H-AVI的患者在12个月时SBP或AVI显著降低。此外,根据CR组基线时CI或CVRR的平均值,将CR组患者分为H-和L-CI或CVRR。CR组中L-CI或L-CVRR的患者在12个月后有显著改善。总之,CR可能会使通过简单无创检查获得的各种血流动力学参数达到适当水平。