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运动计划改善未矫正房间隔缺损相关肺动脉高压患者的功能能力和生活质量:一项随机对照试验性研究

Exercise Program Improves Functional Capacity and Quality of Life in Uncorrected Atrial Septal Defect-Associated Pulmonary Arterial Hypertension: A Randomized-Control Pilot Study.

作者信息

Rakhmawati Annis, Achmad Indera Noor, Hartopo Anggoro Budi, Anggrahini Dyah Wulan, Arso Irsad Andi, Emoto Noriaki, Dinarti Lucia Kris

机构信息

Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Jogjakarta, Indonesia.

Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.

出版信息

Ann Rehabil Med. 2020 Dec;44(6):468-480. doi: 10.5535/arm.20100. Epub 2020 Dec 31.

Abstract

OBJECTIVE

To assess the effect of combined hospital and home-based exercise programs on functional capacity and quality of life (QoL) among uncorrected atrial septal defect-associated pulmonary arterial hypertension (ASD-PAH) patients.

METHODS

This study was a randomized controlled trial with uncorrected ASD-PAH patients as the subjects. They were allocated randomly into control and exercise groups. Exercise group subjects performed hospital and home-based exercise programs, completing baseline 6-minute walking test (6MWT) and EQ-5D-3L QoL test (Utility Index and EQ-VAS scores), and were followed up for 12 weeks. The primary outcomes were 6MWT distance and EQ-5D-3L score at week 12. The N-terminal pro B-type natriuretic peptide (NT-proBNP) level was also assessed. A repeated-measure ANOVA was performed to detect endpoint differences over time.

RESULTS

The exercise group contained 20 subjects and control group contained 19. In total, 19 exercise group subjects and 16 control group subjects completed the protocol. The 6MWT distance, Utility Index score, and EQ-VAS score incrementally improved significantly in the exercise group from baseline until week 12, with mean differences of 76.7 m (p<0.001), 0.137 (p<0.001) and 15.5 (p<0.001), respectively. Compared with the control group, the exercise group had significantly increased 6MWT distance and utility index score at week 12. The EQ-VAS score increased in the exercise group at week 12. The NT-proBNP level decreased at week 12 in the exercise group.

CONCLUSION

Combined hospital and home-based exercise program added to PAH-targeted therapy, improving functional capacity and QoL in uncorrected ASD-PAH patients.

摘要

目的

评估联合医院和家庭锻炼计划对未经矫正的房间隔缺损相关性肺动脉高压(ASD-PAH)患者功能能力和生活质量(QoL)的影响。

方法

本研究是以未经矫正的ASD-PAH患者为对象的随机对照试验。他们被随机分为对照组和锻炼组。锻炼组受试者执行医院和家庭锻炼计划,完成基线6分钟步行试验(6MWT)和EQ-5D-3L生活质量测试(效用指数和EQ-VAS评分),并随访12周。主要结局指标为第12周时的6MWT距离和EQ-5D-3L评分。还评估了N末端B型利钠肽原(NT-proBNP)水平。采用重复测量方差分析来检测随时间的终点差异。

结果

锻炼组有20名受试者,对照组有19名。总共有19名锻炼组受试者和16名对照组受试者完成了方案。锻炼组的6MWT距离、效用指数评分和EQ-VAS评分从基线到第12周均显著逐步改善,平均差异分别为76.7米(p<0.001)、0.137(p<0.001)和15.5(p<0.001)。与对照组相比,锻炼组在第12周时6MWT距离和效用指数评分显著增加。锻炼组在第12周时EQ-VAS评分增加。锻炼组在第12周时NT-proBNP水平下降。

结论

在PAH靶向治疗基础上增加联合医院和家庭锻炼计划,可改善未经矫正的ASD-PAH患者的功能能力和生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/085b/7808796/992c5647d03d/arm-20100f1.jpg

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