非缺血性扩张型心肌病患者心脏康复的疗效：一项初步研究。

The effectiveness of cardiac rehabilitation in non-ischemic dilated cardiomyopathy patients: A pilot study.

机构信息

Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.

出版信息

J Formos Med Assoc. 2020 Feb;119(2):627-634. doi: 10.1016/j.jfma.2019.08.018. Epub 2019 Aug 31.

DOI:10.1016/j.jfma.2019.08.018

PMID:31481287

Abstract

BACKGROUND/PURPOSE: We aimed to investigate the efficacy of cardiac rehabilitation (CR) through parameters of cardiopulmonary exercise testing (CPET) and echocardiography in non-ischemic dilated cardiomyopathy (DCM) patients.

METHODS

We retrospectively identified non-ischemic DCM patients through medical records (between October 2011 and October 2018) in rehabilitation outpatient-clinics. Patients were divided into rehabilitation and control groups. Patients in the rehabilitation group eligible for inclusion had CR for 3-6 months. Control group patients were without rehabilitation. We recorded CPET and echocardiography parameters at the baseline and follow-up time-points. For safety evaluation, we investigated all adverse effects during training sessions. We utilized Mann-Whitney U test for between- and Wilcoxon signed-rank test for within-group comparisons.

RESULTS

Twenty-five patients (14 in rehabilitation and 11 in control group) were included. In the rehabilitation group, significantly increased peak V˙O/kg, peak V˙O%, peak workload and peak O pulse were observed after completing CR, and echocardiographic parameters including left ventricular ejection fraction and end-systolic volume. Rehabilitation group patients demonstrated better improvement (change from the baseline) in peak V˙O/kg, peak V˙O% and peak workload vs. control. No adverse effects during rehabilitation trainings were observed.

CONCLUSION

For non-ischemic DCM, rehabilitation led to superior cardiopulmonary outcomes vs. no rehabilitation, without adverse effects.

摘要

背景/目的：我们旨在通过心肺运动测试（CPET）和超声心动图参数来研究非缺血性扩张型心肌病（DCM）患者心脏康复（CR）的疗效。

方法

我们通过康复门诊病历（2011 年 10 月至 2018 年 10 月间）回顾性地确定了非缺血性 DCM 患者。患者被分为康复组和对照组。有资格纳入康复组的患者接受了 3-6 个月的 CR。对照组患者未接受康复。我们记录了基线和随访时的 CPET 和超声心动图参数。为了评估安全性，我们调查了训练过程中的所有不良反应。我们使用 Mann-Whitney U 检验进行组间比较，Wilcoxon 符号秩检验进行组内比较。

结果

共纳入 25 名患者（康复组 14 例，对照组 11 例）。在康复组中，完成 CR 后，峰值 V˙O/kg、峰值 V˙O%、峰值工作量和峰值 O 脉冲明显增加，左心室射血分数和收缩末期容积等超声心动图参数也得到改善。与对照组相比，康复组患者的峰值 V˙O/kg、峰值 V˙O%和峰值工作量的改善更为显著（与基线相比的变化）。康复训练过程中未观察到不良反应。