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急性冠状动脉综合征患者门诊心脏康复后的功能改善与左心室射血分数的改善无关。

Functional Improvement After Outpatient Cardiac Rehabilitation in Acute Coronary Syndrome Patients is Not Related to Improvement in Left Ventricular Ejection Fraction.

作者信息

Peretti A, Maloberti Alessandro, Garatti L, Palazzini M, Triglione N, Occhi L, Sioli S, Sun J W, Moreo A, Beretta G, Giannattasio C, Riccobono S

机构信息

Cardiac Rehabilitation, Cardiology 4, Niguarda Hospital, Piazza Ospedale Maggiore 3, 20159, Milan, Italy.

School of Medicine and Surgery, Milano-Bicocca University, Milan, Italy.

出版信息

High Blood Press Cardiovasc Prev. 2020 Jun;27(3):225-230. doi: 10.1007/s40292-020-00374-1. Epub 2020 Mar 26.

Abstract

INTRODUCTION

Cardiac rehabilitation (CR) improves the functional capacity and the prognosis of patients with coronary artery disease.

AIM

Our study was aimed at assessing the relationship between functional improvement (evaluated with 6-min Walk Test-6MWT) and the improvement in left ventricular ejection fraction (LVEF) after CR.

METHODS

We collected data from 249 patients (age 66.79 ± 11.06 years; males 81.52%) with a recent history of Acute Coronary Syndrome that performed CR. The functional improvement after CR was expressed as the Δ between distance covered at the final versus the initial 6-min Walking Test (6-MWT), while LVEF was calculated with transthoracic echocardiogram at the beginning and at the end of the CR.

RESULTS

Patients were divided accordingly to their pre-rehab LVEF (≥ 55% vs < 55%). With superimposable age and baseline 6MWT distance covered (434.58 vs 405.12 m, p = 0.08), the latter group presented higher Δ meter values at 6MWT (167.93 vs 193.97 m, p = 0.018). However, no statistically significant positive correlation between Δ meters and Δ LVEF was found. Moreover, linear regression analyses found that nor baseline LVEF nor Δ LVEF were significant determinants of Δ meters when considering the whole group, with age, basal 6MWT and peak CK-MB as additional covariates in the model.

CONCLUSION

Although it could be expected that an increase in LVEF is related to the functional improvement after CR, no significant correlation was found in our population.

摘要

引言

心脏康复(CR)可改善冠状动脉疾病患者的功能能力和预后。

目的

我们的研究旨在评估功能改善(通过6分钟步行试验-6MWT评估)与心脏康复后左心室射血分数(LVEF)改善之间的关系。

方法

我们收集了249例近期有急性冠状动脉综合征病史且接受心脏康复的患者的数据(年龄66.79±11.06岁;男性占81.52%)。心脏康复后的功能改善表示为最终与初始6分钟步行试验(6-MWT)所覆盖距离之间的差值(Δ),而LVEF在心脏康复开始时和结束时通过经胸超声心动图计算得出。

结果

患者根据康复前的LVEF(≥55%与<55%)进行分组。在年龄和基线6MWT覆盖距离可叠加的情况下(434.58米对405.12米,p = 0.08),后一组在6MWT时的Δ米值更高(167.93米对193.97米,p = 0.018)。然而,未发现Δ米与ΔLVEF之间存在统计学上显著的正相关。此外,线性回归分析发现,在考虑整个组时,无论是基线LVEF还是ΔLVEF都不是Δ米的显著决定因素,模型中还加入了年龄、基础6MWT和峰值CK-MB作为额外协变量。

结论

尽管可以预期LVEF的增加与心脏康复后的功能改善有关,但在我们的研究人群中未发现显著相关性。

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