Telecardiology Center, National Institute of Cardiology, Alpejska 42, 04-628 Warsaw, Poland.
National Institute of Cardiology, Alpejska 42 Street, 04-628 Warsaw, Poland.
Eur J Cardiovasc Nurs. 2022 Aug 29;21(6):568-577. doi: 10.1093/eurjcn/zvab125.
The hybrid comprehensive telerehabilitation (HCTR) consisting of telecare (with psychological telesupport), telerehabilitation, and remote monitoring of cardiovascular implantable electronic devices might be an option to improve both physical capacity and depressive symptoms. The aim of the study was to investigate the influence of HCTR on depressive symptoms and physical capacity in heart failure (HF) patients in comparison with usual care (UC).
The present analysis formed part of a multicentre, randomized trial that enrolled 850 HF patients (New York Heart Association I-III, left ventricular ejection fraction ≤ 40%). Patients were randomized 1:1 to HCTR or UC. Patients underwent an HCTR programme (1 week in hospital and 8 weeks at home; exercise training 5 times weekly) or UC with observation. The Beck Depression Inventory II (BDI-II) score (cut point for depression ≥ 14) was used to assess depression and the physical capacity was measured by peak oxygen consumption (peak VO2; mL/kg/min). Measurements were made before and after 9-week intervention/observation (HCTR/UC group). Both groups were comparable in terms of demographic and clinical characteristics. In HCTR group, at entry, 23% of the sample obtained BDI-II scores ≥14 vs. 27.5% in UC group. There were no significant differences between groups regarding ΔBDI-II score (P = 0.992) after 9-week HCTR/UC. There was a significant improvement in physical capacity only in the HCTR group in both patients with (P = 0.033) and without (P < 0.001) depression.
In HF patients, HCTR provided similar reduction of depressive symptoms as UC. HCTR resulted in a significant improvement in physical capacity in patients with and without depression.
综合远程康复（HCTR）包括远程护理（提供心理远程支持）、远程康复以及心血管植入电子设备的远程监测，这可能是改善身体能力和抑郁症状的一种选择。本研究的目的是比较 HCTR 与常规护理（UC）对心力衰竭（HF）患者抑郁症状和身体能力的影响。
本分析是一项多中心、随机试验的一部分，该试验纳入了 850 例 HF 患者（纽约心脏协会 I-III 级，左心室射血分数≤40%）。患者以 1:1 的比例随机分为 HCTR 或 UC 组。患者接受 HCTR 方案（住院 1 周，家庭 8 周；每周 5 次运动训练）或 UC 加观察。采用贝克抑郁量表 II（BDI-II）评分（抑郁切点≥14）评估抑郁，用峰值摄氧量（peak VO2；mL/kg/min）测量身体能力。在 9 周干预/观察后（HCTR/UC 组）进行测量。两组在人口统计学和临床特征方面具有可比性。在 HCTR 组，入组时有 23%的样本获得 BDI-II 评分≥14，而 UC 组为 27.5%。9 周 HCTR/UC 后，两组间ΔBDI-II 评分无显著差异（P = 0.992）。仅在 HCTR 组中，无论是否存在抑郁，患者的身体能力均有显著改善（P = 0.033）。
在 HF 患者中，HCTR 提供了与 UC 相似的抑郁症状缓解效果。HCTR 可显著改善抑郁和非抑郁患者的身体能力。
