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患者起始时的生理状态决定住院心血管康复项目的成功与否。

The Patient's Physiological Status at the Start Determines the Success of the Inpatient Cardiovascular Rehabilitation Program.

作者信息

Odrovicsné-Tóth Anna, Thauerer Bettina, Stritzinger Barbara, Kullich Werner, Salzer Andreas, Skoumal Martin, Steinecker-Frohnwieser Bibiane

机构信息

Ludwig Boltzmann Institute for Arthritis and Rehabilitation, 5760 Saalfelden, Austria.

Rehabilitation Center of the Austrian Pension Insurance Company (PVA), 5760 Saalfelden, Austria.

出版信息

J Clin Med. 2023 Feb 21;12(5):1735. doi: 10.3390/jcm12051735.

Abstract

Multidisciplinary inpatient rehabilitation plays an important role in the recovery of patients with cardiovascular diseases (CVDs). Lifestyle changes, achieved by exercise, diet, weight loss and patient education programs, are the first steps to a healthier life. Advanced glycation end products (AGEs) and their receptor (RAGE) are known to be involved in CVDs. Clarification on whether initial AGE levels can influence the rehabilitation outcome is important. Serum samples were collected at the beginning and end of the inpatient rehabilitation stay and analyzed for parameters: lipid metabolism, glucose status, oxidative stress, inflammation and AGE/RAGE-axis. As result, a 5% increase in the soluble isoform RAGE (sRAGE) (T: 891.82 ± 44.97 pg/mL, T: 937.17 ± 43.29 pg/mL) accompanied by a 7% decrease in AGEs (T: 10.93 ± 0.65 µg/mL, T: 10.21 ± 0.61 µg/mL) was shown. Depending on the initial AGE level, a significant reduction of 12.2% of the AGE activity (quotient AGE/sRAGE) was observed. We found that almost all measured factors improved. Summarizing, CVD-specific multidisciplinary rehabilitation positively influences disease-associated parameters, and thus provides an optimal starting point for subsequent disease-modifying lifestyle changes. Considering our observations, the initial physiological situations of patients at the beginning of their rehabilitation stay seem to play a decisive role regarding the assessment of rehabilitation success.

摘要

多学科住院康复在心血管疾病(CVD)患者的康复中起着重要作用。通过运动、饮食、体重减轻和患者教育计划实现的生活方式改变,是迈向更健康生活的第一步。已知晚期糖基化终末产物(AGEs)及其受体(RAGE)与心血管疾病有关。明确初始AGE水平是否会影响康复结果很重要。在住院康复开始和结束时采集血清样本,并分析以下参数:脂质代谢、血糖状态、氧化应激、炎症以及AGE/RAGE轴。结果显示,可溶性RAGE亚型(sRAGE)增加了5%(T:891.82±44.97 pg/mL,T:937.17±43.29 pg/mL),同时AGEs减少了7%(T:10.93±0.65 µg/mL,T:10.21±0.61 µg/mL)。根据初始AGE水平,观察到AGE活性(AGE/sRAGE商)显著降低了12.2%。我们发现几乎所有测量因素都有所改善。总之,针对CVD的多学科康复对疾病相关参数有积极影响,从而为后续改变疾病的生活方式改变提供了最佳起点。考虑到我们的观察结果,患者康复开始时的初始生理状况似乎对康复成功的评估起着决定性作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8487/10003145/ebdfc12958cf/jcm-12-01735-g001.jpg

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