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心脏康复在改善心肌梗死后结局中的作用。

Role of Cardiac Rehabilitation in Improving Outcomes After Myocardial Infarction.

作者信息

Nemani Raghu Ram Shanmukh, Gade Bala Sushritha, Panchumarthi Dedeepya, Bathula Bhargava Venkata Sasidhar Reddy, Pendli Ganesh, Panjiyar Binay K

机构信息

Medicine, GSL Medical College, Rajahmundry, IND.

Medicine, Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar, IND.

出版信息

Cureus. 2023 Dec 21;15(12):e50886. doi: 10.7759/cureus.50886. eCollection 2023 Dec.

Abstract

Myocardial infarction, an integral part of acute coronary syndrome (ACS), occurs due to atherosclerotic narrowing of the coronary (heart) blood vessels. Acute coronary syndrome, being one of the major cardiovascular diseases (CVDs), has led to a significant amount of mortality and morbidity, the majority of it due to MI. Over a long period following an MI, the physical, psychological, social, emotional, and occupational well-being are greatly impacted. Cardiac rehabilitation (CR) can address the above and help improve long-term well-being and overall quality of life. The benefits of CR include enhanced exercise capacity, risk factor reduction, improved quality of life (QOL), reduced mortality, and hospital readmissions. We used a systematic literature review (SLR) approach in this article to provide a global overview of cutting-edge CR in the post-MI phase. We reviewed 45 articles from journals of good repute published between 2013 and December 1st, 2023, focusing on seven selected papers for in-depth analysis. The analysis was focused on factors such as the positive outcomes of CR and the effects of CR post-MI. There are only a few statistically significant studies in a few domains of CR benefits, namely decreased mortality, cardiac events, depression, depression-associated mortality, hospital readmissions, increased left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDD), left ventricular end-systolic volume (LVESV), metabolic equivalent of task (MET), maximal oxygen consumption (VO2max), and the six-minute walk test (6MWT), and as a result, increased physical performance. Further research is needed to enhance the understanding of its mechanisms and statistically prove its effectiveness in all other domains. As CR continues to evolve, referral and participation in CR should be increased as it improves overall health and well-being.

摘要

心肌梗死是急性冠状动脉综合征(ACS)的一个重要组成部分,它是由于冠状动脉(心脏)血管的动脉粥样硬化性狭窄所致。急性冠状动脉综合征作为主要的心血管疾病(CVD)之一,已导致大量的死亡率和发病率,其中大部分归因于心肌梗死。在心肌梗死后的很长一段时间里,身体、心理、社会、情感和职业幸福感都会受到极大影响。心脏康复(CR)可以解决上述问题,并有助于改善长期幸福感和整体生活质量。心脏康复的益处包括运动能力增强、危险因素降低、生活质量(QOL)改善、死亡率降低以及住院再入院率降低。在本文中,我们采用了系统文献综述(SLR)方法,以全面概述心肌梗死后阶段的前沿心脏康复情况。我们查阅了2013年至2023年12月1日期间发表在知名期刊上的45篇文章,重点对7篇选定论文进行深入分析。分析聚焦于心脏康复的积极成果以及心肌梗死后心脏康复的效果等因素。在心脏康复益处的几个领域,即死亡率降低、心脏事件、抑郁症、抑郁症相关死亡率、住院再入院率、左心室射血分数(LVEF)增加、左心室舒张末期内径(LVEDD)、左心室收缩末期容积(LVESV)、代谢当量(MET)、最大耗氧量(VO2max)和六分钟步行试验(6MWT),从而提高身体机能方面,只有少数具有统计学意义的研究。因此,需要进一步研究以加深对其机制的理解,并从统计学上证明其在所有其他领域的有效性。随着心脏康复的不断发展,由于它能改善整体健康和幸福感,应增加心脏康复的转诊和参与度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6552/10799544/05fdf23ca9ce/cureus-0015-00000050886-i01.jpg

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