Department of Physical Therapy, Fukushima Medical University School of Health Sciences, 10-6, Sakaemachi, Fukushima, 960-8516, Japan.
Department of Cardiology, Southern Tohoku General Hospital, Koriyama, Japan.
Heart Vessels. 2024 May;39(5):393-403. doi: 10.1007/s00380-023-02354-6. Epub 2024 Jan 8.
Acute myocardial infarction (AMI) is associated with a decline in renal function. This study aimed to investigate the impact of engaging in moderate to vigorous intensity physical activity (MVPA) for more than 30 min per day on changes in renal function during the first 3 months after AMI onset. A prospective, observational study was conducted, enrolling 87 patients (75 men; average age, 65.2 ± 12.5 years) who had experienced AMI. The cystatin C-based estimated glomerular filtration rate (eGFRcys) was collected at and 3 months after discharge. Daily MVPA was measured using triaxial accelerometers at a threshold of 3.0 Metabolic equivalent of the task for 3 months. Generalized estimating equations (GEE) were applied to evaluate the longitudinal association between the number of days per week of MVPA for 30 min or more and within-patient changes in eGFRcys. The patients were categorized into three groups based on their MVPA engagement days: 0 days (n = 20), 1-2 days (n = 14), and 3-7 days (n = 53) groups. After adjusting for potential confounding variables, GEE analysis revealed that the eGFRcys slope over 3 months was significantly higher in the 3-7 days group than in 0 days group (B = 2.9, (95% confidence interval: 1.5-4.2), p < 0.001). Similar results were obtained when MVPA time thresholds were set to 40 and 60 min. These findings suggest a significant positive effect of engaging in MVPA for 30 min or more for 3-7 days per week in the improvement of renal function after AMI onset.
急性心肌梗死(AMI)与肾功能下降有关。本研究旨在探讨每天进行 30 分钟以上的中等到剧烈强度体力活动(MVPA)对 AMI 发病后 3 个月内肾功能变化的影响。进行了一项前瞻性观察性研究,共纳入 87 名患者(75 名男性;平均年龄 65.2±12.5 岁),这些患者均经历过 AMI。在出院时和出院后 3 个月收集基于半胱氨酸蛋白酶抑制剂的估计肾小球滤过率(eGFRcys)。使用三轴加速度计以 3.0 代谢当量任务的阈值测量 3 个月的每日 MVPA。广义估计方程(GEE)用于评估每周进行 30 分钟或更长时间的 MVPA 天数与 eGFRcys 患者内变化之间的纵向关联。根据 MVPA 参与天数将患者分为三组:0 天(n=20)、1-2 天(n=14)和 3-7 天(n=53)组。在调整了潜在的混杂变量后,GEE 分析显示,3-7 天组的 eGFRcys 斜率在 3 个月内明显高于 0 天组(B=2.9,95%置信区间:1.5-4.2,p<0.001)。当 MVPA 时间阈值设置为 40 和 60 分钟时,也得到了类似的结果。这些发现表明,AMI 发病后每周进行 3-7 天、每天进行 30 分钟或更长时间的 MVPA 对改善肾功能有显著的积极影响。