Bryndal Aleksandra, Glowinski Sebastian, Grochulska Agnieszka
Department of Physiotherapy, Institute of Health Sciences, Slupsk Pomeranian University, 76200 Slupsk, Poland.
State Higher School of Vocational Education in Koszalin, 75-582 Koszalin, Poland.
J Clin Med. 2022 Sep 23;11(19):5597. doi: 10.3390/jcm11195597.
(1) Background: Prognosis in patients with cardiovascular diseases is significantly influenced by lifestyle and the control of risk factors. Patients after myocardial infarction require special care and promptly introduced cardiac rehabilitation. The primary aim of this study was to identify risk factors and their influence on exercise tolerance before and after cardiac rehabilitation (CR) provided under the Coordinated Specialist Care Programme-Infarct (CSC-Infarct). (2) Methods: The study was carried out at the Cardiac Rehabilitation Centre of Slupsk Specialist Hospital on a group of 112 patients aged 35-87 (62.78 ± 10.09 years) after myocardial infarction (MI), participating in CSC-Infarct. An exercise test (treadmill ECG test), the 6 min walk test (6MWT), echocardiography, blood test (total cholesterol, HDL, LDL, TG), measurement of diastolic pressure ratio (DPr), waist-to-hip ratio (WHR), and BMI were performed in participants on the first and last day of CR. Rating of perceived exertion was assessed with Borg's scale. (3) Results: The overweight variable had the strongest effect on the increased value of initial: HR rest, HR max, and HR 1 min after exercise compared to subjects with normal BMI. DPr values before and after CR were also higher in overweight patients. Scores of 6MWT were higher in smokers compared to non-smokers. The final MET value was significantly higher in non-diabetic subjects. Hyperlipidaemia was associated with a higher initial HR max and initial HR 1 min after exercise. DPr before CR was also higher. The initial and final MET values were lower in hypertensive patients. Borg's rating of perceived exertion measured after the final exercise test was also higher in hypertensive patients. Hypertension influenced the initial and final 6MWT scores, which were significantly higher in normotensive patients. (4) Conclusions: CR within CSC-infarction in patients after myocardial infarction improves exercise tolerance. Exercise tolerance in post-MI patients with concomitant risk factors is lower compared to post-MI patients without risk factors.
(1) 背景：心血管疾病患者的预后受生活方式和危险因素控制的显著影响。心肌梗死后的患者需要特殊护理并及时开展心脏康复。本研究的主要目的是确定在协调专科护理计划 - 心肌梗死（CSC - 梗死）下进行心脏康复（CR）前后的危险因素及其对运动耐量的影响。(2) 方法：该研究在斯武普斯克专科医院心脏康复中心对112名年龄在35 - 87岁（62.78 ± 10.09岁）的心肌梗死（MI）后参与CSC - 梗死的患者进行。在CR的第一天和最后一天，对参与者进行运动测试（跑步机心电图测试）、6分钟步行测试（6MWT）、超声心动图、血液检测（总胆固醇、高密度脂蛋白、低密度脂蛋白、甘油三酯）、舒张压比值（DPr）测量、腰臀比（WHR）和体重指数（BMI）测量。用伯格量表评估主观用力程度分级。(3) 结果：与体重指数正常的受试者相比，超重变量对静息心率、最大心率和运动后1分钟心率增加值的影响最强。超重患者CR前后的DPr值也更高。吸烟者的6MWT得分高于非吸烟者。非糖尿病受试者的最终代谢当量（MET）值显著更高。高脂血症与运动后较高的初始最大心率和初始1分钟心率相关。CR前的DPr也更高。高血压患者的初始和最终MET值较低。高血压患者在最后一次运动测试后测得的伯格主观用力程度分级也更高。高血压影响初始和最终的6MWT得分，血压正常的患者得分显著更高。(4) 结论：心肌梗死后患者在CSC - 梗死计划内进行CR可提高运动耐量。与无危险因素的心肌梗死后患者相比，伴有危险因素的心肌梗死后患者的运动耐量较低。
