Department of Internal Medicine & Rehabilitation Science Disability Science, Tohoku University Graduate School of Medicine.
Department of Rehabilitation, Ohta General Hospital Foundation, Ohta Nishinouchi Hospital.
Circ J. 2021 Apr 23;85(5):612-622. doi: 10.1253/circj.CJ-20-0970. Epub 2021 Feb 4.
This study investigated the effect of outpatient cardiac rehabilitation (OCR) and physical activity on the estimated glomerular filtration rate based on serum cystatin C (eGFRcys) in patients with heart disease (HD) aged ≥75 years.
This non-randomized prospective intervention study involved 136 patients (non-OCR group, n=66; OCR group, n=70), 55 of whom were aged ≥75 years (non-OCR group, n=29; OCR group, n=26). Renal function (eGFRcys) was evaluated at discharge and 3 months thereafter. A linear mixed model (LMM) was used to assess changes in renal function over time. The hospital readmission rate within 3 months after discharge was also evaluated. LMM analysis showed that the change in eGFRcys was -2.27 and +0.48 mL/min/1.73 min the non-OCR and OCR groups, respectively (F=2.960, P=0.022). Further, among patients aged ≥75 years in the non-OCR and OCR groups, the change in eGFRcys was -3.83 and -1.08 mL/min/1.73 m, respectively (F=2.719, P=0.039). The proportion of patients aged ≥75 years who were rehospitalized due to exacerbation of HD was 16.9% (n=10) and 6.7% (n=2) in the non-OCR and OCR groups, respectively.
Among patients with HD aged ≥75 years, participation in OCR reduces the decline in renal function and hospital readmission rates.
本研究旨在探讨门诊心脏康复(OCR)和体力活动对血清胱抑素 C(eGFRcys)估算肾小球滤过率(eGFR)的影响。
本非随机前瞻性干预研究纳入了 136 名患者(非 OCR 组 66 例,OCR 组 70 例),其中 55 例年龄≥75 岁(非 OCR 组 29 例,OCR 组 26 例)。在出院时和 3 个月后评估肾功能(eGFRcys)。采用线性混合模型(LMM)评估肾功能随时间的变化。还评估了出院后 3 个月内的住院再入院率。LMM 分析显示,eGFRcys 的变化在非 OCR 组和 OCR 组分别为-2.27 和+0.48 mL/min/1.73 min(F=2.960,P=0.022)。此外,在非 OCR 组和 OCR 组≥75 岁的患者中,eGFRcys 的变化分别为-3.83 和-1.08 mL/min/1.73 m(F=2.719,P=0.039)。非 OCR 组和 OCR 组因 HD 恶化而再次住院的患者比例分别为 16.9%(n=10)和 6.7%(n=2)。
在≥75 岁的 HD 患者中,参与 OCR 可降低肾功能下降和住院再入院率。