Department of Cardiology, Bispebjerg Frederiksberg University Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark.
Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Eur J Prev Cardiol. 2024 Nov 18;31(16):1950-1957. doi: 10.1093/eurjpc/zwae195.
The ability to be physically active is pivotal to the quality of life in elderly patients. This study aims to describe the association between exercise capacity and health-related quality of life (HRQoL), anxiety, and depression following an exercise-based cardiac rehabilitation (CR) programme in elderly cardiac patients.
Patients aged ≥65 years with acute and chronic coronary syndrome or heart valve surgery were consecutively included from eight CR centres in seven European countries. Exercise capacity [VO2peak(mL/kg/min)] was assessed with a cardiopulmonary exercise test (97%) or a 6-min walk test. Outcome variables included HRQoL [36-item Short-Form Health Survey physical and mental component scores (PCS and MCS)], anxiety (Generalized Anxiety Disorder-7), and depression (Patient Health Questionnaire-9). Mixed models were used to address the association between baseline and the development in VO2peak, and outcome variables stratified on sex, and adjusted for baseline values, age, and CR centre. A total of 1633 patients were included (T0), 1523 (93%) completed end-of-CR assessment (T1), and 1457 (89%) were available for 1-year follow-up (T2). Women had higher percentage of predicted VO2peak but poorer scores in HRQoL, anxiety, and depression at all time points. All scores improved in both sexes at follow-up. We found significant associations between VO2peak at baseline as well as development in VO2peak and all outcome variables at T1 and T2 in men (all P < 0.001). In women, VO2peak was only associated with PCSs (P < 0.001).
Improvements in exercise capacity were strongly associated with improvements in HRQoL and mental health, however, with stronger associations in men. The results highlight the importance of physical fitness for HRQol and mental health. The findings from this study might be useful to better target individual CR programmes.
身体活跃能力对于老年患者的生活质量至关重要。本研究旨在描述在老年心脏患者进行基于运动的心脏康复（CR）计划后，运动能力与健康相关生活质量（HRQoL）、焦虑和抑郁之间的关系。
从七个欧洲国家的八个 CR 中心连续纳入年龄≥65 岁的急性和慢性冠状动脉综合征或心脏瓣膜手术患者。运动能力[峰值摄氧量（mL/kg/min）]使用心肺运动试验（97%）或 6 分钟步行试验进行评估。结局变量包括 HRQoL[36 项简短健康调查身体和精神成分评分（PCS 和 MCS）]、焦虑（广泛性焦虑障碍-7）和抑郁（患者健康问卷-9）。混合模型用于解决基线和 VO2peak 发展之间的关联，并根据性别对结局变量进行分层，同时调整基线值、年龄和 CR 中心。共纳入 1633 例患者（T0），1523 例（93%）完成 CR 结束评估（T1），1457 例（89%）可进行 1 年随访（T2）。女性的预测 VO2peak 百分比较高，但在所有时间点的 HRQoL、焦虑和抑郁评分均较差。在随访时，两性的所有评分均有所改善。我们发现基线时的 VO2peak 以及 VO2peak 的发展与男性在 T1 和 T2 时的所有结局变量之间存在显著关联（均 P < 0.001）。在女性中，VO2peak 仅与 PCS 相关（P < 0.001）。
运动能力的提高与 HRQoL 和心理健康的改善密切相关，但在男性中关联更强。研究结果强调了身体健康对 HRQol 和心理健康的重要性。本研究的结果可能有助于更好地针对个体的 CR 计划。
