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通过心脏康复提高运动能力的预测因素:性别和年龄很重要。

Predictors of gain in exercise capacity through cardiac rehabilitation: Sex and age matter.

作者信息

Fuentes Artiles Rubén, Euler Sebastian, Auschra Bianca, da Silva Hadassa Brito, Niederseer David, Schmied Christian, von Känel Roland, Jellestad Lena

机构信息

Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Department of Medicine, Limmattal Hospital, Schlieren, Switzerland.

Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.

出版信息

Heart Lung. 2023 Nov-Dec;62:200-206. doi: 10.1016/j.hrtlng.2023.08.003. Epub 2023 Aug 8.

Abstract

BACKGROUND

Cardiac rehabilitation (CR) is a cornerstone of secondary prevention that improves cardiovascular outcomes. However, the determinants of treatment success are poorly understood.

OBJECTIVES

We investigated the associations of health-related quality of life (HRQoL), sex, age, employment status and housing situation with improvement in exercise capacity throughout CR.

METHODS

We analyzed data from 392 CR outpatients (81% men and 19% women). Exercise capacity at baseline and upon completion of the program was measured with the 6-minute walk distance (6MWD). HRQoL at CR entry was assessed with the Short Form 36 Health Survey (SF-36).

RESULTS

A multivariable regression analysis revealed that both men and women showed significant improvement in exercise capacity (p < .001). Female sex (B = 18.118, 95% CI 0.341 - 36.035, p = .046) and younger age (B = -0.887, 95% CI -1.463 - -0.312, p = .003) emerged as predictors of greater improvement, while HRQoL, employment status, and housing situation were not associated with significant change in exercise capacity. The final model explained 25% of the variance in exercise capacity change (adjusted R = 0.25, p < .001).

CONCLUSIONS

Our results indicate that women and younger participants benefit from CR by improving their exercise capacity. Employment status, housing situation and HRQoL showed no effects on CR outcome.

摘要

背景

心脏康复(CR)是二级预防的基石,可改善心血管疾病预后。然而,治疗成功的决定因素尚不清楚。

目的

我们研究了健康相关生活质量(HRQoL)、性别、年龄、就业状况和住房情况与整个心脏康复过程中运动能力改善之间的关联。

方法

我们分析了392名心脏康复门诊患者的数据(81%为男性,19%为女性)。采用6分钟步行距离(6MWD)测量基线和项目完成时的运动能力。在心脏康复开始时,使用简短健康调查问卷(SF-36)评估健康相关生活质量。

结果

多变量回归分析显示,男性和女性的运动能力均有显著改善(p <.001)。女性(B = 18.118,95%CI 0.341 - 36.035,p =.046)和较年轻的年龄(B = -0.887,95%CI -1.463 - -0.312,p =.003)是运动能力改善更大的预测因素,而健康相关生活质量、就业状况和住房情况与运动能力的显著变化无关。最终模型解释了运动能力变化中25%的方差(调整后R = 0.25,p <.001)。

结论

我们的结果表明,女性和年轻参与者通过提高运动能力从心脏康复中获益。就业状况、住房情况和健康相关生活质量对心脏康复结果没有影响。

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