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门诊心脏康复后峰值摄氧量变化的预测因素:心脏康复出勤率的重要性。

Predictors of Changes in Peak Oxygen Uptake After Outpatient Cardiac Rehabilitation: Importance of Cardiac Rehabilitation Attendance.

作者信息

Little Kasara A, Smith Joshua R, Medina-Inojosa Jose R, Chacin Suarez Audry S, Taylor Jenna L, Hammer Shane M, Fischer Karen M, Bonikowske Amanda R, Squires Ray W, Thomas Randal J, Olson Thomas P

机构信息

Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN.

Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN.

出版信息

Mayo Clin Proc Innov Qual Outcomes. 2022 Sep 2;6(5):428-435. doi: 10.1016/j.mayocpiqo.2022.07.002. eCollection 2022 Oct.

Abstract

OBJECTIVE

To determine whether the number of cardiac rehabilitation (CR) sessions attended and selected clinical characteristics were predictive of patients who exhibited improvement in peak oxygen uptake (VOpeak) after CR.

PATIENTS AND METHODS

Using the Rochester Epidemiology Project records-linkage system, we identified all consecutive patients aged 18 years or older from Olmsted County, Minnesota, who underwent cardiopulmonary exercise testing before and after CR from 1999 to 2017. Regression models were created to assess the clinical predictors of VOpeak improvement (>0% baseline) after CR.

RESULTS

The analysis included 671 patients, of which 524 (78%) patients exhibited VOpeak improvement after CR. The significant univariate predictors of VOpeak improvement included younger age (odds ratio [OR], 0.98; 95% CI, 0.96-0.99), lower pre-CR VOpeak (OR, 0.96; 95% CI, 0.94-0.99), and no history of peripheral artery disease (OR, 0.50; 95% CI, 0.31-0.81) (all, <.005). The significant independent predictors of VOpeak improvement from the multivariable analysis included the number of CR sessions (OR, 1.04; 95% CI, 1.02-1.05), younger age (OR, 0.96; 95% CI, 0.94-0.98), lower pre-CR VOpeak (OR, 0.92; 95% CI, 0.89-0.95), and no history of peripheral artery disease (OR, 0.47; 95% CI, 0.28-0.78) (all, <.005).

CONCLUSION

These findings highlight the importance of patient participation in CR sessions and individual clinical characteristics in influencing VOpeak improvement after CR in patients with cardiovascular disease.

摘要

目的

确定参加心脏康复(CR)的疗程数以及选定的临床特征是否可预测CR后峰值摄氧量(VOpeak)出现改善的患者。

患者与方法

利用罗切斯特流行病学项目记录链接系统,我们识别了明尼苏达州奥尔姆斯特德县所有18岁及以上、在1999年至2017年期间接受CR前后进行心肺运动测试的连续患者。建立回归模型以评估CR后VOpeak改善(>基线0%)的临床预测因素。

结果

分析纳入671例患者,其中524例(78%)患者CR后VOpeak出现改善。VOpeak改善的显著单因素预测因素包括年龄较小(比值比[OR],0.98;95%置信区间[CI],0.96 - 0.99)、CR前VOpeak较低(OR,0.96;95% CI,0.94 - 0.99)以及无外周动脉疾病史(OR,0.50;95% CI,0.31 - 0.81)(均P <.005)。多变量分析中VOpeak改善的显著独立预测因素包括CR疗程数(OR,1.04;95% CI,1.02 - 1.05)、年龄较小(OR,0.96;95% CI,0.94 - 0.98)、CR前VOpeak较低(OR,0.92;95% CI,0.89 - 0.95)以及无外周动脉疾病史(OR,0.47;95% CI,0.28 - 0.78)(均P <.005)。

结论

这些发现凸显了患者参与CR疗程以及个体临床特征在影响心血管疾病患者CR后VOpeak改善方面的重要性。

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本文引用的文献

1
Sex Differences in Cardiac Rehabilitation Outcomes.心脏康复结局的性别差异。
Circ Res. 2022 Feb 18;130(4):552-565. doi: 10.1161/CIRCRESAHA.121.319894. Epub 2022 Feb 17.
3
Response to Exercise Training During Cardiac Rehabilitation Differs by Sex.运动康复训练对性别的反应不同。
J Cardiopulm Rehabil Prev. 2020 Sep;40(5):319-324. doi: 10.1097/HCR.0000000000000536.

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