Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, Australia; Sydney Medical School, University of Sydney, Camperdown, Australia; Discipline of Exercise and Sport Science, University of Sydney, Camperdown, Australia; Heart Research Institute, Newtown, Australia.
School of Physiotherapy and Exercise Science, Curtin University, Bentley, Australia; Allied Health Department, Fiona Stanley Hospital, Murdoch, Australia.
Ann Thorac Surg. 2021 Oct;112(4):1045-1054. doi: 10.1016/j.athoracsur.2020.08.118. Epub 2020 Dec 4.
In the current era, the majority of children born with congenital heart disease (CHD) will survive well into adulthood because of major advances in surgical techniques, as well as in critical and medical care. However, reoperation and palliative surgical interventions are increasingly common in the adults with CHD. Tools to risk stratify patients effectively and therapies to improve outcomes are required to optimize the management of adult patients with CHD during the preoperative and postoperative periods and beyond. Exercise testing is an invaluable tool to guide risk stratification. In addition, exercise training in patients with CHD may decrease postoperative complications by enhancing physiological reserve and also has an important role in physical rehabilitation. This review aims to provide individualized recommendations on exercise prescription in patients with CHD in the preoperative and postoperative settings. The response to exercise testing and prognostic implications is also discussed.
在当前时代，由于手术技术以及重症和医疗护理方面的重大进步，大多数患有先天性心脏病 (CHD) 的儿童都能很好地活到成年。然而，患有 CHD 的成年人越来越多地需要再次手术和姑息性手术干预。需要有效的风险分层工具和改善预后的治疗方法，以优化成人 CHD 患者在术前、术后以及术后的管理。运动测试是指导风险分层的宝贵工具。此外，CHD 患者的运动训练可以通过增强生理储备来减少术后并发症，并且在身体康复方面也具有重要作用。这篇综述旨在为术前和术后患者提供关于 CHD 患者运动处方的个性化建议。还讨论了对运动测试的反应和预后意义。
