基于运动的心肌血运重建术后心脏康复：系统评价和荟萃分析。
Exercise-based cardiac rehabilitation after myocardial revascularization: a systematic review and meta-analysis.
机构信息
Department of Biological Sciences, University of the State of Minas Gerais - Carangola Unit, 36800-000 Carangola, Brazil.
Department of Physiology and Biophysics, Institute of Biological Sciences, Federal University of Minas Gerais, 31270-901 Belo Horizonte, Brazil.
出版信息
Rev Cardiovasc Med. 2022 Feb 22;23(2):74. doi: 10.31083/j.rcm2302074.
BACKGROUND
The present study aimed to analyze the effects of exercise-based cardiac rehabilitation (CR) on physical performance after myocardial revascularization. In addition, we compared the type and duration of exercise-based CR protocols to determine which ones produced the best performance improvements.
METHODS
This systematic review and meta-analysis was conducted and reported in accordance with PRISMA statement. A systematic search of PubMed, Web of Science, SPORTDiscus and ProQuest, was performed in July 2020. Studies that met the following criteria were included: (i) participants submitted to myocardial revascularization (i.e., coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI)), (ii) participants submitted to exercise-based CR, and (iii) participants submitted to protocols for assessing physical performance before and after the exercise-based CR.
RESULTS
Thirteen and eleven studies evaluating the effects of exercise-based CR after myocardial revascularization were included in the systematic review and meta-analysis, respectively. Exercise-based CR increased physical performance after myocardial revascularization (mean effect size (ES) 0.75; 95% confidence interval (CI) 0.62, 0.88), particularly when aerobic (ES 0.85; 95% CI 0.68, 1.01) and combined training (ES 1.04; 95% CI 0.70, 1.38) lasting 8-12 weeks (ES 1.20; 95% CI 0.87, 1.53) was prescribed.
CONCLUSIONS
The present systematic review and meta-analysis indicates that exercise-based CR increases physical performance after myocardial revascularization. The prescription of physical training for these patients should emphasize aerobic and combined training lasting at least 8-12 weeks, which is more effective in improving physical performance.
IMPACT
Our findings demonstrate the effectiveness of physical training in improving physical performance after myocardial revascularization.
背景
本研究旨在分析基于运动的心脏康复（CR）对心肌血运重建后身体表现的影响。此外，我们比较了基于运动的 CR 方案的类型和持续时间，以确定哪些方案能产生最佳的表现改善。
方法
本系统评价和荟萃分析按照 PRISMA 声明进行并报告。于 2020 年 7 月对 PubMed、Web of Science、SPORTDiscus 和 ProQuest 进行了系统检索。纳入符合以下标准的研究：（i）参与者接受了心肌血运重建（即冠状动脉旁路移植术（CABG）和经皮冠状动脉介入治疗（PCI）），（ii）参与者接受了基于运动的 CR，（iii）参与者接受了评估基于运动的 CR 前后身体表现的方案。
结果
有 13 项和 11 项研究分别纳入系统评价和荟萃分析，以评估心肌血运重建后基于运动的 CR 的效果。基于运动的 CR 增加了心肌血运重建后的身体表现（平均效应量（ES）0.75；95%置信区间（CI）0.62，0.88），尤其是当规定持续 8-12 周的有氧运动（ES 0.85；95% CI 0.68，1.01）和组合训练（ES 1.04；95% CI 0.70，1.38）时（ES 1.20；95% CI 0.87，1.53）。
结论
本系统评价和荟萃分析表明，基于运动的 CR 可提高心肌血运重建后的身体表现。对这些患者进行身体训练的处方应强调持续至少 8-12 周的有氧运动和组合训练，这更能有效提高身体表现。
影响
我们的研究结果表明，身体训练可有效改善心肌血运重建后的身体表现。
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