Szadkowska Iwona, Szmigielska Katarzyna
Department of Sports Medicine, Medical University of Lodz, 92-231 Lodz, Poland.
Outpatient Rehabilitation Unit, Central Teaching Hospital of the Medical University of Lodz, Pomorska 251, 92-231 Lodz, Poland.
J Clin Med. 2024 May 17;13(10):2969. doi: 10.3390/jcm13102969.
: Despite the use of advanced treatment techniques, coronary artery disease (CAD) still remains the main cause of left ventricular (LV) dysfunction and heart failure. Participation in cardiac rehabilitation (CR) programs can lead to a number of beneficial effects, but some patients do not demonstrate the expected improvement. The aim of this study is to evaluate the impact of CR on changes in exercise capacity with regard to the presence of LV dysfunction. : A group of 428 patients with CAD were consecutively admitted to an outpatient comprehensive cardiac rehabilitation program comprising 24 exercise sessions of interval training on cycle ergometers, three times a week for 45 min, and a health education. The patients were compared in two subgroups, i.e., with LV systolic dysfunction (LVEF < 50%, = 175) and LVEF ≥ 50% ( = 253). : In the LVEF < 50% group, the exercise capacity improved by 1 ± 0.78 MET (median 1.15 MET), and 0.86 ± 0.77 MET (median 1.08 MET) in the LVEF ≥ 50% group. Women with LVEF < 50% demonstrated a significant increase in exercise capacity by 1.2 MET, while those with LVEF ≥ 50% did not display any such increase. All men, regardless of LVEF, exhibited a similar improvement in exercise capacity greater than 1 MET. : An outpatient eight-week cardiac rehabilitation program based on 45 min aerobic interval training sessions three times a week appears less effective for women with CAD and EF ≥ 50%. In this group, the proposed training intervention is insufficient in improving exercise capacity to an extent that could indicate a reduction in mortality risk.
尽管采用了先进的治疗技术,但冠状动脉疾病(CAD)仍然是左心室(LV)功能障碍和心力衰竭的主要原因。参与心脏康复(CR)计划可带来诸多有益效果,但部分患者并未表现出预期的改善。本研究旨在评估CR对存在LV功能障碍患者运动能力变化的影响。
一组428例CAD患者连续纳入一项门诊综合心脏康复计划,该计划包括24次在周期测力计上进行的间歇训练运动课程,每周三次,每次45分钟,以及健康教育。将患者分为两个亚组进行比较,即LV收缩功能障碍组(左心室射血分数[LVEF]<50%,n = 175)和LVEF≥50%组(n = 253)。
在LVEF<50%组中,运动能力提高了1±0.78代谢当量(MET)(中位数为1.15 MET),而在LVEF≥50%组中提高了0.86±0.77 MET(中位数为1.08 MET)。LVEF<50%的女性运动能力显著提高了1.2 MET,而LVEF≥50%的女性则未表现出此类提高。所有男性,无论LVEF如何,运动能力均有相似的提高,超过1 MET。
一项基于每周三次、每次45分钟有氧间歇训练课程的为期八周的门诊心脏康复计划,对CAD且EF≥50%的女性似乎效果较差。在该组中,所提议的训练干预在提高运动能力方面不足以表明可降低死亡风险。