Hospital Israelita Albert Einstein - Instituto de Educação e Pesquisa, São Paulo, SP - Brasil.
Universidade Nove de Julho - Programa de Pós-graduação em Medicina, São Paulo, SP - Brasil.
Arq Bras Cardiol. 2022 Jul;119(1):59-66. doi: 10.36660/abc.20210386.
Previous cross-sectional studies have demonstrated that physical activity is associated with lower cardiovascular risk in patients with peripheral artery disease (PAD). However, it is not possible to establish causality, and longitudinal design studies are required.
To analyze the changes in cardiovascular risk parameters and physical activity levels after a 2-year follow-up in patients with symptomatic PAD.
This study started in 2015. In the first phase, 268 patients were included. In the second phase, after 2 years (median = 26 months), 72 patients were re-evaluated. Cardiovascular risk parameters, such as blood pressure, cardiac autonomic modulation, and arterial stiffness, and physical activity levels were measured at baseline and after 2 years of follow-up. Association among delta changes (values from follow-up - baseline) in physical activity and cardiovascular parameters were analyzed by multiple linear regression. The significance level was set at p < 0.05.
Patients reduced their total physical activity levels compared to baseline (baseline = 2257.6 ± 774.5 versus follow-up = 2041 ± 676.2 min/week, p = 0.001). After follow-up, ankle-brachial index (0.62 ± 0.20 versus 0.54 ± 0.20, p = 0.003), and standard deviation of all RR intervals (43.4 ± 27.0 versus 25.1 ± 13.4 ms, p < 0.001) were lower, whereas carotid-femoral pulse wave velocity was higher (9.0 ± 3.0 versus 10.7 ± 3.4 m/s, p = 0.002) compared to baseline values. We did not observe any association among delta values of physical activity levels and cardiovascular risk parameters.
Patients with PAD had reduced physical activity levels and impaired cardiovascular risk parameters during 2-year follow-up.
先前的横断面研究表明，在患有外周动脉疾病（PAD）的患者中，身体活动与较低的心血管风险相关。然而，无法确定因果关系，需要进行纵向设计研究。
分析有症状的 PAD 患者经过 2 年随访后心血管风险参数和身体活动水平的变化。
本研究于 2015 年开始。在第一阶段，纳入了 268 名患者。在第二阶段，2 年后（中位数=26 个月），重新评估了 72 名患者。在基线和 2 年随访后，测量了心血管风险参数，如血压、心脏自主神经调节和动脉僵硬，以及身体活动水平。通过多元线性回归分析身体活动和心血管参数的变化差值（随访值-基线值）之间的关系。显著性水平设置为 p < 0.05。
与基线相比，患者的总身体活动水平降低（基线=2257.6±774.5 分钟/周，随访=2041±676.2 分钟/周，p=0.001）。随访后，踝臂指数（0.62±0.20 与 0.54±0.20，p=0.003）和所有 RR 间期的标准差（43.4±27.0 与 25.1±13.4 ms，p<0.001）降低，而颈动脉-股动脉脉搏波速度升高（9.0±3.0 与 10.7±3.4 m/s，p=0.002）。我们没有观察到身体活动水平的变化差值与心血管风险参数之间的任何关联。
在 2 年随访期间，PAD 患者的身体活动水平降低，心血管风险参数受损。
