Kim Ki-Hong, Jang Yun-Chol, Song Min-Keun, Park Hyeng-Kyu, Choi In-Sung, Han Jae-Young
Department of Physical and Rehabilitation Medicine, Chonnam National University Medical School and Hospital, Gwangju, Korea.
Ann Rehabil Med. 2020 Feb;44(1):77-84. doi: 10.5535/arm.2020.44.1.77. Epub 2020 Feb 29.
To test the hypothesis that a longer duration of phase II cardiac rehabilitation is required to recover the exercise capacity of elderly patients compared to younger patients.
We retrospectively reviewed and analyzed the medical records of patients who were referred to our cardiac rehabilitation (CR) center and underwent percutaneous coronary intervention for acute myocardial infarction (AMI). A total of 70 patients were enrolled who underwent an exercise tolerance test (ETT) 3 weeks after the occurrence of an AMI (T0), 6 weeks after the first ETT (T1), and 12 weeks after the first ETT (T2). Patients older than 65 years were assigned to the elderly group (n=24) and those aged 65 years and younger to the younger group (n=46). Both groups performed center-based or home-based CR for 12 weeks (3 times per week and 1 session per day). Exercise intensity for each individual was based on the target heart rate calculated by the Karvonen formula. The change in maximal metabolic equivalents (METmax) of the two groups was measured at each assessment point (T0, T1, and T2) to investigate the recovery of exercise capacity.
The younger group showed improvement in METmax between T0 and T1. However, METmax of the elderly group showed no significant improvement between T0 and T1. The exercise capacity, measured with METmax, of all groups showed improvement between T0 and T2.
Elderly patients with AMI need a longer duration of CR (>6 weeks) than younger patients with AMI.
验证与年轻患者相比,老年患者需要更长时间的二期心脏康复才能恢复运动能力这一假设。
我们回顾性分析了被转诊至我们心脏康复(CR)中心并接受急性心肌梗死(AMI)经皮冠状动脉介入治疗的患者的病历。共纳入70例患者,他们在AMI发生后3周(T0)、首次运动耐量测试(ETT)后6周(T1)以及首次ETT后12周(T2)接受了运动耐量测试。年龄大于65岁的患者被分配至老年组(n = 24),65岁及以下的患者被分配至年轻组(n = 46)。两组均进行了为期12周(每周3次,每天1次)的中心或家庭心脏康复。每个人的运动强度基于卡尔森公式计算的目标心率。在每个评估点(T0、T1和T2)测量两组的最大代谢当量(METmax)变化,以研究运动能力的恢复情况。
年轻组在T0和T1之间METmax有所改善。然而,老年组在T0和T1之间METmax没有显著改善。所有组以METmax衡量的运动能力在T0和T2之间均有所改善。
与年轻的AMI患者相比,老年AMI患者需要更长时间(>6周)的心脏康复。