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冠心病合并急性心力衰竭患者早期I期心脏康复对经阻抗心动图评估的心脏功能的影响

Effects of early phase 1 cardiac rehabilitation on cardiac function evaluated by impedance cardiography in patients with coronary heart disease and acute heart failure.

作者信息

Wang Yishu, Xiao Yanchao, Tang Jianjun, Liu Yutao, Li Hui, Peng Zengjin, Xu Danyan, Shen Li

机构信息

Department of Internal Cardiovascular Medicine, Second Xiangya Hospital, Central South University, Changsha, China.

The First People's Hospital of Xiangtan City, Xiangtan, China.

出版信息

Front Cardiovasc Med. 2022 Aug 24;9:958895. doi: 10.3389/fcvm.2022.958895. eCollection 2022.

Abstract

PURPOSE

The purpose of the study was to access the impact of phase 1 cardiac rehabilitation (CR) on cardiac function and hemodynamic changes in patients with coronary heart disease (CHD) and acute heart failure (AHF).

MATERIALS AND METHODS

A total of 98 patients with CHD and AHF were recruited and randomized into two groups. Control group received standard pharmacotherapy and CR group received standard pharmacotherapy combined phase 1 CR. NT-proBNP and hemodynamic parameters measured by impedance cardiography (ICG) were estimated at baseline and at the end of treatment period.

RESULTS

Phase 1 CR combined routine medical treatment could lower NT-proBNP levels. The percentage of high-risk patients was significantly decreased in CR group, although the post-treatment NT-proBNP level between control group and CR group showed no significant differences. Similarly, most hemodynamic parameters improved in the CR group, but not in the control group, suggesting that phase 1 CR in combination with the standard pharmacotherapy improved hemodynamic characteristics by elevating cardiac output, ameliorating preload, improving systolic and diastolic function, and relieving afterload, although the post-treatment hemodynamic parameters showed no statistically significant differences between the control group and the CR group.

CONCLUSION

Phase 1 CR combined routine medication can improve cardiac function and hemodynamic characteristics in patients with CHD and AHF. Thus, recommendation of phase 1 CR to stable patients is necessary.

摘要

目的

本研究旨在探讨冠心病(CHD)合并急性心力衰竭(AHF)患者进行一期心脏康复(CR)对心脏功能及血流动力学变化的影响。

材料与方法

共招募98例CHD合并AHF患者,随机分为两组。对照组接受标准药物治疗,CR组接受标准药物治疗联合一期CR。在基线期和治疗期末通过阻抗心动图(ICG)测量N末端脑钠肽前体(NT-proBNP)及血流动力学参数。

结果

一期CR联合常规药物治疗可降低NT-proBNP水平。CR组高危患者比例显著降低,尽管对照组与CR组治疗后NT-proBNP水平无显著差异。同样,CR组多数血流动力学参数改善,而对照组未改善,这表明一期CR联合标准药物治疗通过提高心输出量、改善前负荷、增强收缩和舒张功能以及减轻后负荷来改善血流动力学特征,尽管对照组与CR组治疗后血流动力学参数无统计学显著差异。

结论

一期CR联合常规药物治疗可改善CHD合并AHF患者的心脏功能及血流动力学特征。因此,对病情稳定的患者推荐一期CR是必要的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0409/9449118/b2b3ee37e22d/fcvm-09-958895-g001.jpg

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