Itoh Hidetaka, Amiya Eisuke, Jimba Takahiro, Shimbo Mai, Narita Koichi, Taya Masanobu, Kadokami Toshiaki, Yasu Takanori, Oka Hideki, Sogawa Masakazu, Yokoi Hiroyoshi, Mizutani Kazuo, Miura Shin-Ichiro, Tokeshi Tatsuo, Date Ayumi, Noma Takahisa, Kutsuzawa Daisuke, Usui Soichiro, Sugawara Shigeo, Kanazawa Masanori, Sekino Hisakuni, Nishitani Yokoyama Miho, Okumura Takahiro, Ugata Yusuke, Fujishima Shinichiro, Hirabayashi Kagami, Ishizaki Yuta, Kuwahara Koichiro, Kaji Yuko, Shimizu Hiroki, Koyama Teruyuki, Adachi Hitoshi, Kurumatani Yoko, Taniguchi Ryoji, Ohori Katsuhiko, Shiraishi Hirokazu, Hasegawa Takashi, Makita Shigeru, Komuro Issei, Kimura Yutaka
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Int J Cardiol Heart Vasc. 2024 May 17;52:101421. doi: 10.1016/j.ijcha.2024.101421. eCollection 2024 Jun.
Remote cardiac rehabilitation has proven useful in patients with cardiovascular disease; however, the methodology had not been fully validated. This study aimed to investigate the efficacy and safety of remote cardiac rehabilitation (RCR) with real-time monitoring and an ergometer using a bidirectional communication tool during the recovery phase of cardiovascular diseases.
This multicenter, nonrandomized, interventional study was conducted at 29 institutions across Japan and enrolled patients with cardiovascular diseases who met indications for cardiac rehabilitation (CR) after receiving in-hospital treatment. The RCR group exercised at home using an ergometer and was monitored in real-time using interactive video and monitoring tools for 2-3 months. Educational instructions were provided concurrently through e-learning approaches. The safety of the RCR protocol and the improvement in peak oxygen consumption (VO2) were compared with those of the historical control group that participated in center-based CR.
Fifty-three patients from the RCR group were compared with 103 historical controls having similar background characteristics. No patients in RCR experienced significant cardiovascular complications while engaging in exercise sessions. After 2-3 months of RCR, the peak VO2 improved significantly, and the increases in the RCR group did not exhibit any significant differences compared to those in the historical controls. During follow-up, the proportion of patients whose exercise capacity increased by 10% or more was also evaluated; this finding did not indicate a statistically significant distinction between the groups.
RCR during the recovery phase of cardiovascular diseases proved equally efficient and safe as center-based CR.
远程心脏康复已被证明对心血管疾病患者有用；然而，该方法尚未得到充分验证。本研究旨在调查在心血管疾病康复阶段使用双向通信工具进行实时监测和功率计的远程心脏康复（RCR）的疗效和安全性。
这项多中心、非随机、干预性研究在日本全国29家机构进行，纳入了在接受住院治疗后符合心脏康复（CR）指征的心血管疾病患者。RCR组在家中使用功率计进行锻炼，并使用交互式视频和监测工具进行实时监测，为期2至3个月。同时通过电子学习方法提供教育指导。将RCR方案的安全性和峰值耗氧量（VO2）的改善情况与参加基于中心的CR的历史对照组进行比较。
将RCR组的53例患者与103例具有相似背景特征的历史对照者进行比较。RCR组中没有患者在锻炼期间出现重大心血管并发症。经过2至3个月的RCR，峰值VO2有显著改善，RCR组的增加与历史对照组相比没有显示出任何显著差异。在随访期间，还评估了运动能力提高10%或更多的患者比例；这一发现并未表明两组之间存在统计学上的显著差异。
心血管疾病康复阶段的RCR被证明与基于中心的CR同样有效和安全。
