Taylor Jenna L, Medina-Inojosa Jose R, Chacin-Suarez Audry, Smith Joshua R, Squires Ray W, Thomas Randal J, Johnson Bruce D, Olson Thomas P, Bonikowske Amanda R
Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States.
Human Integrative and Environmental Physiology Laboratory, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States.
Front Cardiovasc Med. 2022 Apr 14;9:872757. doi: 10.3389/fcvm.2022.872757. eCollection 2022.
We investigated age-related differences for peak oxygen uptake (peak VO) improvement with exercise training during cardiac rehabilitation (CR).
This was a retrospective cohort study of the Mayo Clinic Rochester CR program including adult patients who attended CR (≥1 session) for any eligible indication between 1999 and 2017 and who had a cardiopulmonary exercise test pre and post CR with VO data (peak respiratory exchange ratio ≥1.0). Younger (20-49 yrs), midlife (50-64 yrs), and older adults (≥65 yrs) were compared using ANOVA for delta and percent change in peak VO; and percentage of peak VO responders (>0% change).
708 patients (age: 60.8 ± 12.1 years; 24% female) met inclusion criteria. Delta and percent change in peak VO was lower for older adults (1.6 ± 3.2 mL.kg.min; 12 ± 27%) compared with younger (3.7 ± 4.0 mL.kg.min, < 0.001; 23 ± 28%, = 0.002) and midlife adults (2.8 ± 3.8 mL.kg.min, < 0.001; 17 ± 28%, = 0.04). For midlife, delta change, but not percent change in peak VO was significantly lower ( = 0.02) compared with younger. Percentage of responders was only different between older and younger (72 vs. 86%; = 0.008). Sensitivity analyses in non-surgical patients showed similar differences for delta change, and differences in percent change remained significant between older and younger adults (10 ± 20% vs. 16 ± 18%; = 0.04).
In CR patients, older adults had lower improvement in cardiorespiratory fitness than younger and midlife adults. While excluding surgical patients reduced age-related differences, older adults still had lower cardiorespiratory fitness improvement during CR. These findings may have implications for individualizing CR programming in aging populations to reduce future cardiovascular risk.
我们研究了心脏康复（CR）期间运动训练对峰值摄氧量（peak VO₂）改善的年龄相关差异。
这是一项对梅奥诊所罗切斯特CR项目的回顾性队列研究，纳入了1999年至2017年间因任何符合条件的适应症参加CR（≥1次）且在CR前后进行了心肺运动测试并获得VO₂数据（峰值呼吸交换率≥1.0）的成年患者。使用方差分析比较年轻人（20 - 49岁）、中年（50 - 64岁）和老年人（≥65岁）的peak VO₂变化量和变化百分比；以及peak VO₂反应者的百分比（变化>0%）。
708例患者（年龄：60.8±12.1岁；24%为女性）符合纳入标准。与年轻人（3.7±4.0 mL·kg⁻¹·min，P<0.001；23±28%，P = 0.002）和中年成年人（2.8±3.8 mL·kg⁻¹·min，P<0.001；17±28%，P = 0.04）相比，老年人的peak VO₂变化量和变化百分比更低（1.6±3.2 mL·kg⁻¹·min；12±27%）。对于中年人与年轻人相比，peak VO₂的变化量显著更低（P = 0.02），但变化百分比无显著差异。反应者百分比仅在老年人和年轻人之间存在差异（72%对86%；P = 0.008）。非手术患者的敏感性分析显示，变化量存在类似差异，老年人和年轻人之间的变化百分比差异仍然显著（10±20%对16±18%；P = 0.04）。
在CR患者中，老年人的心肺适能改善低于年轻人和中年成年人。虽然排除手术患者减少了年龄相关差异，但老年人在CR期间的心肺适能改善仍然较低。这些发现可能对老年人群CR方案的个体化以降低未来心血管风险具有启示意义。
