Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine.
Cardiovascular Rehabilitation and Fitness, Juntendo University Hospital.
Circ J. 2018 Dec 25;83(1):101-109. doi: 10.1253/circj.CJ-18-0738. Epub 2018 Nov 8.
Cardiac rehabilitation (CR) is an established multidisciplinary secondary preventive program. We investigated the effects of CR involving intensive physical activity (PA) on coronary plaque volume and components in patients with acute coronary syndrome (ACS).
We enrolled 32 consecutive patients with ACS in early phase II CR and randomly assigned them to an intensive CR group (n=18; CR participation ≥twice/week, daily PA ≥9,000 steps) or a standard CR group (n=14; CR participation ≥once/2weeks, daily PA ≥6,000 steps). Serial integrated backscatter intravascular ultrasound was performed for non-culprit lesions at baseline and after 8 months. Baseline clinical data were identical between the 2 groups. Unexpectedly, CR participation and PA did not differ significantly between the 2 groups, and there was no significant difference in plaque volume (PV) or components between the 2 groups. Subsequently, we classified the patients into 2 groups according to median PA (7,000 steps). There were significant differences in percent change of PV and of lipid volume between these 2 groups. In addition, these changes were negatively and independently correlated with PA.
No significant difference was observed in PV or components between the intensive CR and the standard CR groups. Intensive PA, however, may retard coronary PV and ameliorate lipid component in patients with ACS participating in late phase II CR.
心脏康复(CR)是一种成熟的多学科二级预防项目。我们研究了包含强化体力活动(PA)的 CR 对急性冠状动脉综合征(ACS)患者冠状动脉斑块体积和成分的影响。
我们招募了 32 名处于早期 II 期 CR 的连续 ACS 患者,并将他们随机分配到强化 CR 组(n=18;CR 参与≥每周 2 次,每日 PA≥9000 步)或标准 CR 组(n=14;CR 参与≥每 2 周 1 次,每日 PA≥6000 步)。在基线和 8 个月时对非罪犯病变进行连续回波背向散射积分血管内超声检查。两组基线临床数据相同。出乎意料的是,两组之间的 CR 参与和 PA 没有显著差异,两组之间斑块体积(PV)或成分也没有显著差异。随后,我们根据中位 PA(7000 步)将患者分为两组。这两组之间的 PV 和脂质体积的百分比变化有显著差异。此外,这些变化与 PA 呈负相关且独立相关。
强化 CR 和标准 CR 两组之间 PV 或成分没有显著差异。然而,在晚期 II 期 CR 中,强化 PA 可能会减缓 ACS 患者的冠状动脉 PV 并改善脂质成分。