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运动对肺动脉高压患者睡眠和心肺参数的影响。

Effect of exercise on sleep and cardiopulmonary parameters in patients with pulmonary artery hypertension.

机构信息

Faculty of physical therapy, Cairo University, Cairo, Egypt.

出版信息

Sleep Breath. 2021 Dec;25(4):1953-1960. doi: 10.1007/s11325-020-02286-9. Epub 2021 Feb 18.

Abstract

BACKGROUND

Pulmonary arterial hypertension (PAH) is considered to be a rare progressive disease resulting from restricted flow through the pulmonary arterial circulation resulting ultimately in right-sided heart failure. Most patients with PAH suffer from sleep disorders, reduced aerobic fitness, and mortality risk despite optimized medical treatment. This study investigated the effect of 12 weeks of aerobic training on sleep quality, sleep efficiency, right ventricular systolic pressure (RVSP), and aerobic fitness in patients with PAH.

METHODS

Thirty patients with PAH were randomized to two equal groups, training group (A) and control group (B). The Pittsburg sleep quality index (PSQI) questionnaire and a wrist-worn actigraph were used for the assessment of sleep quality and sleep efficiency respectively. RVSP was measured using echocardiography. Cardiopulmonary exercise testing (CPET) assessed maximal heart rate and VO2max. All were measured before and after the study period for both groups. Exercise training was conducted on a bicycle ergometer as an individually-tailored moderate-intensity aerobic training session (60 to 70% of the maximal heart rate reached during the initial exercise test) for 30 to 45 min/day, 3 sessions/week for 12 weeks (36 sessions).

RESULTS

Sleep scores and RVSP showed significant reductions and VO2max-representing the aerobic fitness-showed a significant increase in the group (A) compared with group (B).

CONCLUSION

These results suggest that aerobic training has a positive effect on three risk factors for mortality in patients with PAH, namely sleep quality, decline in exercise capacity, and right ventricular remodeling.

CLINICAL TRIALS REGISTRATION

Clinical trial registered in ClinicalTrials.gov , ID: NCT04337671.

摘要

背景

肺动脉高压(PAH)被认为是一种罕见的进行性疾病,由肺循环血流受限引起,最终导致右心衰竭。尽管进行了优化的药物治疗,大多数 PAH 患者仍存在睡眠障碍、有氧运动能力下降和死亡风险增加。本研究旨在探讨 12 周有氧运动训练对 PAH 患者睡眠质量、睡眠效率、右心室收缩压(RVSP)和有氧运动能力的影响。

方法

30 例 PAH 患者随机分为两组,即训练组(A)和对照组(B)。匹兹堡睡眠质量指数(PSQI)问卷和腕戴活动记录仪分别用于评估睡眠质量和睡眠效率。RVSP 通过超声心动图测量。心肺运动试验(CPET)评估最大心率和 VO2max。所有患者在研究前后均进行测量。运动训练在自行车测功计上进行,采用个体化定制的中等强度有氧运动方案(达到初始运动试验时最大心率的 60%至 70%),每天 30 至 45 分钟,每周 3 次,共 12 周(36 次)。

结果

与对照组(B)相比,组(A)的睡眠评分和 RVSP 显著降低,VO2max(代表有氧运动能力)显著增加。

结论

这些结果表明,有氧运动训练对 PAH 患者的三个死亡风险因素(即睡眠质量、运动能力下降和右心室重构)具有积极影响。

临床试验注册

ClinicalTrials.gov 注册,ID:NCT04337671。

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