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三级医疗中心外周动脉疾病患者的心脏康复——对6个月后动脉僵硬度和功能状态的影响

Cardiac Rehabilitation in Peripheral Artery Disease in a Tertiary Center-Impact on Arterial Stiffness and Functional Status after 6 Months.

作者信息

Anghel Razvan, Adam Cristina Andreea, Marcu Dragos Traian Marius, Mitu Ovidiu, Roca Mihai, Tinica Grigore, Mitu Florin

机构信息

Clinical Rehabilitation Hospital, Cardiovascular Rehabilitation Clinic, Pantelimon Halipa Street nr 14, 700661 Iași, Romania.

Department of Internal Medicine, University of Medicine and Pharmacy "Grigore T. Popa", University Street nr 16, 700115 Iași, Romania.

出版信息

Life (Basel). 2022 Apr 18;12(4):601. doi: 10.3390/life12040601.

Abstract

Background and Objectives: Cardiac rehabilitation (CR) plays an essential role in peripheral artery disease (PAD), leading to improved functional status, increased quality of life, and reduced arterial stiffness. We aimed to assess factors associated with clinical improvement 6 months after enrolment in a rehabilitation program at an academic medical center in north-eastern Europe. Materials and Methods: We conducted a prospective cohort study on 97 patients with PAD admitted to a single tertiary referral center. At the 6-months follow-up, 75 patients (77.3%) showed improved clinical status. We analyzed demographics and clinical and paraclinical parameters in order to explore factors associated with a favorable outcome. Results: Hypertension (p = 0.002), diabetes mellitus (p = 0.002), dyslipidemia (p = 0.045), and obesity (p = 0.564) were associated with no clinical improvement. Smoking cessation (p < 0.001), changing sedentary lifestyle (p = 0.032), and improvement of lipid and carbohydrate profile as well as functional status parameters and ambulatory arterial stiffness index (p = 0.008) were factors associated with clinical improvement at the 6-months follow-up. Conclusions: PAD patients require an integrative, multidisciplinary management to maintain functional status and increase quality of life. Improving carbohydrate and lipid profile, adopting a healthy lifestyle, quitting smoking and increasing exercise capacity are predictors for clinical improvement 6 months after enrolment in a CR program.

摘要

背景与目的

心脏康复(CR)在外周动脉疾病(PAD)中起着至关重要的作用,可改善功能状态、提高生活质量并降低动脉僵硬度。我们旨在评估在欧洲东北部一家学术医疗中心参加康复项目6个月后与临床改善相关的因素。材料与方法:我们对收治于单一三级转诊中心的97例PAD患者进行了一项前瞻性队列研究。在6个月随访时,75例患者(77.3%)临床状态改善。我们分析了人口统计学、临床及辅助检查参数,以探索与良好结局相关的因素。结果:高血压(p = 0.002)、糖尿病(p = 0.002)、血脂异常(p = 0.045)和肥胖(p = 0.564)与临床无改善相关。戒烟(p < 0.001)、改变久坐生活方式(p = 0.032)以及脂质和碳水化合物谱、功能状态参数和动态动脉僵硬度指数的改善(p = 0.008)是6个月随访时与临床改善相关的因素。结论:PAD患者需要综合、多学科管理以维持功能状态并提高生活质量。改善碳水化合物和脂质谱、采用健康生活方式、戒烟以及提高运动能力是参加CR项目6个月后临床改善的预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0398/9024562/6656f9c4098f/life-12-00601-g001.jpg

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