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经导管主动脉瓣置换术后(ENERGY)中中强度连续训练对改善心肺功能的疗效和安全性:一项随机对照试验。

Efficacy and Safety of Moderate-Intensity Continuous Training on the Improvement of Cardiopulmonary Function in Patients After Transcatheter Aortic Valve Replacement (ENERGY): A Randomized Controlled Trial.

机构信息

Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, China; Department of Cardiology, Air Force Hospital of Western Theater Command, Chengdu, China.

Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, China.

出版信息

J Am Med Dir Assoc. 2023 Nov;24(11):1783-1790.e2. doi: 10.1016/j.jamda.2023.04.025. Epub 2023 Jun 7.

Abstract

OBJECTIVES

To investigate the effect of moderate-intensity continuous training (MICT) on the improvement of cardiopulmonary function for patients undergoing transcatheter aortic valve replacement (TAVR).

DESIGN

Randomized controlled study.

SETTING AND PARTICIPANTS

Between August 20, 2021, and February 28, 2022, a total of 66 patients after TAVR were screened for inclusion and randomly divided into the MICT and control groups at a ratio of 1:1. MICT was scheduled 3 times per week for 3 months in the intervention group. Patients in the control group received one-time advice on physical activity according to the current guideline.

METHODS

The primary endpoint was the 3-month change in peak oxygen consumption (peak VO) assessed by cardiopulmonary exercise testing. The secondary endpoints included the 3-month change in 6-minute walk test (6MWT), the 12-Item Short Form Health Survey (SF-12), New York Heart Association (NYHA) class, echocardiographic parameters, and laboratory parameters.

RESULTS

After 3 months, the change in peak VO was higher in the MICT group than that in the control group (1.63 mL/kg/min, 95% CI 0.58-2.67, P = .003). Change in 6MWT (21.55 m, 95% CI 0.38-42.71, P = .046) was higher in the MICT group compared with the control group. A significant change in favor of MICT was also observed for low-density lipoprotein cholesterol (-0.62 mmol/L, 95% CI -1.00 to -0.23, P = .002). However, there were no significant changes in other echocardiographic indices, laboratory parameters, and SF-12 between the 2 groups (all P > .05).

CONCLUSIONS AND IMPLICATIONS

MICT had a positive effect on the cardiopulmonary function and physical capacity of patients after TAVR.

摘要

目的

研究中等强度连续训练(MICT)对经导管主动脉瓣置换术(TAVR)后患者心肺功能改善的影响。

设计

随机对照研究。

设置和参与者

2021 年 8 月 20 日至 2022 年 2 月 28 日,共筛选出 66 例 TAVR 后患者纳入研究,并按照 1:1 的比例随机分为 MICT 组和对照组。干预组每周进行 3 次 MICT,持续 3 个月。对照组患者根据现行指南接受一次性体力活动建议。

方法

主要终点为心肺运动试验评估的 3 个月时峰值摄氧量(peak VO)的变化。次要终点包括 3 个月时 6 分钟步行试验(6MWT)、12 项简明健康调查量表(SF-12)、纽约心脏协会(NYHA)心功能分级、超声心动图参数和实验室参数的变化。

结果

3 个月后,MICT 组的 peak VO 变化高于对照组(1.63 mL/kg/min,95%CI 0.58-2.67,P =.003)。与对照组相比,MICT 组 6MWT 的变化更大(21.55 m,95%CI 0.38-42.71,P =.046)。MICT 组还观察到低密度脂蛋白胆固醇(-0.62 mmol/L,95%CI -1.00 至-0.23,P =.002)的显著改善。然而,两组间其他超声心动图指标、实验室参数和 SF-12 均无显著变化(均 P >.05)。

结论和意义

MICT 对 TAVR 后患者心肺功能和身体能力有积极影响。

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