Department of Medicine, Division of Hospitalist Medicine, The Miriam Hospital and Brown University Alpert Medical School, Providence, RI, USA.
Department of Medicine, Division of Cardiology, VA Medical Center and Brown University Alpert Medical School, Providence, RI, USA.
Heart Lung. 2021 Mar-Apr;50(2):223-229. doi: 10.1016/j.hrtlng.2020.12.004. Epub 2020 Dec 16.
There is paucity of data on cardiac rehabilitation (CR) enrollment and outcomes in women with heart failure (HF).
In this retrospective analysis, we compared enrollment, adherence and outcomes between women with HF versus coronary artery disease (CAD)-related indications referred to a university-affiliated CR program from June 2014-July 2018. A multivariate regression analysis was performed to adjust for imbalanced variables at baseline and baseline value of each outcome to compare change in outcomes between HF and CAD groups RESULTS: A total of 538 women (HF=63 vs CAD=475) were included in the study. At baseline, women with HF were younger, had lower attendance to CR intake and worse perceived health, higher AACVPR risk category and lower exercise capacity but had similar enrollment, weight and dieatry habits when compared to women with CAD. Adjusted analyses showed that almost all cardiac rehabilitation outcomes except for positive affect (anxiety, depression symptoms, negative affect, dietary habits, perceived physical and mental health summary scores, exercise duration and capacity) improved significantly from baseline and in a similar fashion in both groups. Weight loss was significantly greater for women with CAD versus those with HF (CAD: Δ -1.12 ± 2.23 kg versus HF: Δ -0.66 ± 2.78 kg, p = 0.03).
Despite a lower attendance to CR intake, lower perceived physical health and higher baseline AACVPR risk in women with HF, they have similar CR enrollment, adherence and completion rates compared to women with CAD. Both groups showed significant but similar improvements from baseline in almost all cardiac rehabilitation outcomes. These findings should alert cardiology providers to help overcome obstacles for women with HF to attend CR intake.
心力衰竭（HF）女性患者的心脏康复（CR）参与率和结局数据有限。
在这项回顾性分析中，我们比较了 2014 年 6 月至 2018 年 7 月期间，因心力衰竭（HF）和冠状动脉疾病（CAD）相关适应证被转诊至大学附属 CR 项目的女性患者的参与率、依从性和结局。采用多变量回归分析调整基线时的不平衡变量和每个结局的基线值，以比较 HF 和 CAD 组之间结局的变化。
共纳入 538 名女性患者（HF 组 63 名，CAD 组 475 名）。基线时，HF 组患者年龄较小，CR 摄入量的出席率较低，自我感知健康状况较差，AACVPR 风险类别较高，运动能力较低，但与 CAD 组相比，其参与率、体重和饮食习惯相似。调整分析显示，除积极情绪（焦虑、抑郁症状、消极情绪、饮食习惯、感知身心健康综合评分、运动持续时间和能力）外，几乎所有的 CR 结局均从基线开始显著改善，且两组的改善方式相似。与 HF 组相比，CAD 组的体重减轻更为显著（CAD 组：Δ-1.12±2.23kg，HF 组：Δ-0.66±2.78kg，p=0.03）。
尽管 HF 女性患者的 CR 摄入量出席率较低，自我感知身体健康状况较差，AACVPR 基线风险较高，但与 CAD 患者相比，其 CR 参与率、依从性和完成率相似。两组患者在几乎所有 CR 结局方面均从基线开始出现显著且相似的改善。这些发现应引起心脏病学提供者的警惕，以帮助克服 HF 女性患者参加 CR 摄入的障碍。
