Szmigielska Katarzyna, Jegier Anna
Department of Sports Medicine, Medical University of Lodz, Pomorska 251, 92-213 Łódź, Poland.
J Pers Med. 2022 Apr 8;12(4):600. doi: 10.3390/jpm12040600.
This study evaluated the clinical outcomes of cardiac rehabilitation (CR) in women with coronary artery disease (CAD) in comparison to men. Methods: Patients after acute coronary syndrome or after revascularization procedures (106 women, 180 men) were consecutively admitted to a comprehensive outpatient CR program, comprising of 45-min ergometer interval training three times a week for eight weeks. The training intensity was determined on the basis of training heart rate, calculated following an exercise test. Patients were divided into subgroups according to age (≤55, >55 years), BMI (<25, ≥25 kg/m2), left ventricular ejection fraction (LVEF; ≤40%, 41−49%, ≥50%), and number of affected coronary vessels. Results: After eight weeks, exercise capacity increased significantly by 0.6 ± 0.77 MET (women) and by 1.0 ± 0.74 MET (men). The greatest benefit was observed in men, women under 55 years, women with LVEF 41−49%, and women with single-vessel CAD. An outpatient CR program appears less beneficial for women, especially those over 55 years, with two or three coronary vessels affected with atherosclerosis or with LVEF > 50%. In women with CAD, eight weeks of 45-min interval training, with sessions three times a week, is insufficient to improve exercise capacity to an extent that is considered a predictor of mortality risk reduction.
本研究评估了冠心病（CAD）女性患者与男性患者相比进行心脏康复（CR）的临床结局。方法：急性冠状动脉综合征后或血管重建术后的患者（106名女性，180名男性）连续纳入一个综合门诊CR项目，该项目包括每周三次、每次45分钟的测力计间歇训练，持续八周。训练强度根据运动试验后计算的训练心率来确定。患者根据年龄（≤55岁、>55岁）、体重指数（BMI；<25、≥25kg/m²）、左心室射血分数（LVEF；≤40%、41−49%、≥50%）以及受累冠状动脉血管数量分为亚组。结果：八周后，运动能力显著提高，女性提高了0.6±0.77代谢当量（MET），男性提高了1.0±0.74MET。在男性、55岁以下的女性、LVEF为41−49%的女性以及单支血管CAD的女性中观察到最大益处。门诊CR项目对女性似乎益处较小，尤其是那些55岁以上、有两支或三支冠状动脉受动脉粥样硬化影响或LVEF>50%的女性。在CAD女性患者中，每周三次、每次45分钟的八周间歇训练不足以将运动能力提高到被认为是降低死亡风险预测指标的程度。
