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向 Takotsubo 心肌病患者转介心脏康复治疗和预后评估。

Referral to Cardiac Rehabilitation and Outcomes for Patients With Takotsubo Cardiomyopathy.

机构信息

Division of Cardiology, School of Medicine, Georgetown University, MedStar Washington Hospital Center, Washington, District of Columbia (Dr C. M. Wu); Touro College of Osteopathic Medicine, New York City, New York (Mr McKeon); Division of Cardiology, Warren Alpert Medical School of Brown University, Providence, Rhode Island (Drs Abbott and W.-C. Wu); Veterans Affairs Medical Center, Providence, Rhode Island (Ms Jiang and Dr W.-C. Wu); and Miriam Hospital Center for Cardiac Fitness, Providence, Rhode Island (Dr W.-C. Wu).

出版信息

J Cardiopulm Rehabil Prev. 2019 May;39(3):E8-E11. doi: 10.1097/HCR.0000000000000433.

Abstract

PURPOSE

The aim of this study was to determine participation rates and outcomes for patients with Takotsubo cardiomyopathy (TC) in a cardiac rehabilitation (CR) program.

METHODS

Patients at 2 academic medical centers with a discharge diagnosis of TC from January 2008 to March 2015 were retrospectively identified. Patients meeting the Mayo Clinic criteria for TC were cross-matched to the CR center affiliated with the hospitals to determine the referral rate and outcomes after completion of the program.

RESULTS

In total, 380 unique patients were identified who survived the index hospitalization. Eighteen patients (5%) were referred to CR, 15 enrolled, and of those enrolled, 10 patients (67%) completed the program. Patients undergoing percutaneous coronary intervention of a nonculprit vessel at the time of diagnosis was the only predictor for referral to CR (11% vs 1%, P = .01). The 10 patients who completed CR attended 33 ± 6 (range, 20-36) sessions. Weight and body mass index reduction were 2.8 ± 3.5 lb and 0.6 ± 0.7 kg/m (P = .04, both), respectively. Post-CR exercise duration was 37 ± 4 min/session, which improved by 13 ± 6 min/session from baseline (P < .01). Two patients entered the phase III maintenance program. One-year cardiac readmission rates were comparable among patients who completed CR and those who were referred but did not attend or complete CR (0% vs 13%, P = .47).

CONCLUSIONS

Referral for the TC population was low; however, enrollment and completion rates were adequate, with percutaneous coronary intervention in nonculprit vessel as the only predictor of CR referral. Limited data showed CR may help with weight reduction and improve exercise duration.

摘要

目的

本研究旨在确定 Takotsubo 心肌病(TC)患者在心脏康复(CR)项目中的参与率和结局。

方法

回顾性分析 2008 年 1 月至 2015 年 3 月期间在 2 家学术医疗中心因 TC 出院的患者。将符合梅奥诊所 TC 标准的患者与与医院附属的 CR 中心进行交叉匹配,以确定转诊率和完成项目后的结局。

结果

共有 380 例患者在指数住院期间存活。18 例(5%)患者被转诊至 CR,其中 15 例入组,入组的 10 例(67%)完成了该项目。在诊断时对非罪犯血管进行经皮冠状动脉介入治疗是转诊至 CR 的唯一预测因素(11%比 1%,P =.01)。完成 CR 的 10 例患者参加了 33 ± 6(范围,20-36)次课程。体重和体重指数的降低分别为 2.8 ± 3.5 磅和 0.6 ± 0.7 千克/平方米(均 P =.04)。CR 后的运动时间为 37 ± 4 分钟/次,比基线增加了 13 ± 6 分钟/次(P <.01)。有 2 例患者进入了第三阶段维持计划。完成 CR 和转诊但未参加或未完成 CR 的患者的 1 年心脏再入院率相似(0%比 13%,P =.47)。

结论

TC 人群的转诊率较低;然而,入组率和完成率足够高,非罪犯血管经皮冠状动脉介入治疗是 CR 转诊的唯一预测因素。有限的数据表明 CR 可能有助于减轻体重和增加运动时间。

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