Kong Hyun Ho, Bang Heui Je, Ko Jae Ung, Lee Goo Joo
Department of Rehabilitation Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
Department of Rehabilitation Medicine, Chungbuk National University Hospital, Cheongju, Korea.
Ann Rehabil Med. 2017 Dec;41(6):1047-1054. doi: 10.5535/arm.2017.41.6.1047. Epub 2017 Dec 28.
To determine the age-related changes in cardiac rehabilitation (CR) outcomes, which includes hemodynamic and metabolic factors, in patients with myocardial infarction (MI).
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.
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.
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.
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。
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。
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。
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。