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2016 Focused Update: Clinical Recommendations for Cardiopulmonary Exercise Testing Data Assessment in Specific Patient Populations.2016 年重点更新:特定患者人群心肺运动试验数据评估的临床建议。
Circulation. 2016 Jun 14;133(24):e694-711. doi: 10.1161/CIR.0000000000000406. Epub 2016 May 2.
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Effects of healthy aging on the cardiopulmonary hemodynamic response to exercise.健康老龄化对心肺血流动力学对运动反应的影响。
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Exercise standards for testing and training: a scientific statement from the American Heart Association.测试与训练的运动标准:美国心脏协会的科学声明。
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Pulmonary vascular resistances during exercise in normal subjects: a systematic review.正常受试者运动时的肺血管阻力:系统评价。
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Predictors of cardiac rehabilitation referral in coronary artery disease patients: findings from the American Heart Association's Get With The Guidelines Program.冠心病患者心脏康复转诊的预测因素:美国心脏协会“遵循指南”项目的研究结果
J Am Coll Cardiol. 2009 Aug 4;54(6):515-21. doi: 10.1016/j.jacc.2009.02.080.
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Maximal exercise oxygen pulse as a predictor of mortality among male veterans referred for exercise testing.最大运动氧脉搏作为接受运动测试的男性退伍军人死亡率的预测指标。
Eur J Cardiovasc Prev Rehabil. 2009 Jun;16(3):358-64. doi: 10.1097/HJR.0b013e3283292fe8.
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Aerobic capacity in patients entering cardiac rehabilitation.进入心脏康复治疗的患者的有氧能力。
Circulation. 2006 Jun 13;113(23):2706-12. doi: 10.1161/CIRCULATIONAHA.105.606624. Epub 2006 Jun 5.
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Determinants of referral to cardiac rehabilitation programs in patients with coronary artery disease: a systematic review.冠心病患者心脏康复项目转诊的决定因素:一项系统评价
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心肌梗死患者心脏康复结局的年龄差异:一项初步研究。

The Differences in Cardiac Rehabilitation Outcomes by Age in Myocardial Infarction: A Preliminary Study.

作者信息

Kong Hyun Ho, Bang Heui Je, Ko Jae Ung, Lee Goo Joo

机构信息

Department of Rehabilitation Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.

Department of Rehabilitation Medicine, Chungbuk National University Hospital, Cheongju, Korea.

出版信息

Ann Rehabil Med. 2017 Dec;41(6):1047-1054. doi: 10.5535/arm.2017.41.6.1047. Epub 2017 Dec 28.

DOI:10.5535/arm.2017.41.6.1047
PMID:29354582
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5773425/
Abstract

OBJECTIVE

To determine the age-related changes in cardiac rehabilitation (CR) outcomes, which includes hemodynamic and metabolic factors, in patients with myocardial infarction (MI).

METHODS

CR was administered for 8 weeks to 32 men (mean age, 54.0±8.8 years) who underwent percutaneous coronary intervention for acute MI between July 2012 and January 2016. The exercise tolerance tests were performed before and after the CR. The results were stratified based on a cut-off age of 55 years.

RESULTS

In the whole patient group, the hemodynamic variables such as the resting heart rate (HR), systolic blood pressure (SBP), submaximal HR (HR), SBP (SBP), and rate pressure product (RPP) significantly decreased and the maximal HR (HR) and RPP (RPP) significantly increased. All metabolic variables displayed significant improvement, to include maximal oxygen consumption (VO) and ventilation (V), anaerobic threshold (AT), and the maximal oxygen pulse (O). However, upon stratification by age, those who were younger than 55 years of age exhibited significant changes only in the HR and RPP and those aged 55 years old or greater displayed significant changes in all hemodynamic variables except diastolic BP. Both groups displayed significant increases in the VO, VE, and AT; the older group also exhibited a significant increase in O. The magnitude of the changes in the hemodynamic and metabolic variables before and after CR, based on age, did not differ between the groups; although, it tended to be greater among the older participants of this study's sample.

CONCLUSION

Because the older participants tended to show greater hemodynamic and metabolic changes due to CR, a more aggressive CR program must be administered to elderly patients with MI.

摘要

目的

确定心肌梗死(MI)患者心脏康复(CR)结局与年龄相关的变化,这些结局包括血流动力学和代谢因素。

方法

对2012年7月至2016年1月期间因急性心肌梗死接受经皮冠状动脉介入治疗的32名男性(平均年龄54.0±8.8岁)进行为期8周的心脏康复治疗。在心脏康复治疗前后进行运动耐量测试。结果根据55岁的年龄界限进行分层。

结果

在整个患者组中,静息心率(HR)、收缩压(SBP)、次最大心率(HR)、收缩压(SBP)和心率血压乘积(RPP)等血流动力学变量显著降低,最大心率(HR)和心率血压乘积(RPP)显著增加。所有代谢变量均显示出显著改善,包括最大摄氧量(VO)和通气量(V)、无氧阈值(AT)和最大氧脉搏(O)。然而,按年龄分层后,年龄小于55岁的患者仅在心率和心率血压乘积方面有显著变化,而年龄在55岁及以上的患者除舒张压外,所有血流动力学变量均有显著变化。两组的VO、VE和AT均显著增加;老年组的O也显著增加。基于年龄,两组在心脏康复治疗前后血流动力学和代谢变量的变化幅度没有差异;尽管如此,在本研究样本中年龄较大的参与者中,这种变化幅度往往更大。

结论

由于年龄较大的参与者因心脏康复治疗往往表现出更大的血流动力学和代谢变化,因此必须对老年心肌梗死患者实施更积极的心脏康复计划。