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基于运动的心脏康复对经导管主动脉瓣置换术后慢性心力衰竭患者的影响:一项随机对照试验。

Effect of Exercise-Based Cardiac Rehabilitation on Patients With Chronic Heart Failure After Transcatheter Aortic Valve Replacement: A Randomized Controlled Trial.

作者信息

Song Jingjin, Chen Xiang, Wang Bin, Cheng Ye, Wang Yan

机构信息

Author Affiliation: Department of Cardiology, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China (Song, Chen, Wang, Cheng, and Wang).

出版信息

J Cardiopulm Rehabil Prev. 2025 Jan 1;45(1):51-56. doi: 10.1097/HCR.0000000000000912. Epub 2024 Nov 28.

Abstract

PURPOSE

The objective of this study was to assess the effect of exercise-based cardiac rehabilitation (CR) with individualized exercise prescription in patients with chronic heart failure (HF) undergoing transcatheter aortic valve replacement (TAVR) in a randomized controlled trial.

METHODS

A total of 60 patients with chronic HF who received TAVR treatment were randomly divided into the control group (n = 30) and exercise training (ET) group (n = 30). The control group was treated with conventional rehabilitation, and the ET group was given personalized exercise-based CR based on a cardiopulmonary exercise test (CPX). The CPX parameters, echocardiography, 6-minute walk test distance, and quality of life were evaluated in the two groups.

RESULTS

All patients who completed symptom-restricted CPX showed no complications. After the 12-week rehabilitation period, the levels of anaerobic threshold, peak oxygen uptake, peak oxygen pulse, peak power, left ventricular ejection fraction, and 6-minute walk test distance in the ET group were significantly higher than those in the control group ( P  < .05). Scores on the Minnesota Life with Heart Failure Questionnaire in the ET group were lower than those in the control group ( P < .05).

CONCLUSION

Exercise-based CR significantly improves cardiopulmonary function, exercise tolerance, and quality of life in patients with chronic HF who undergo TAVR.

摘要

目的

本研究的目的是在一项随机对照试验中,评估个体化运动处方的运动心脏康复(CR)对接受经导管主动脉瓣置换术(TAVR)的慢性心力衰竭(HF)患者的影响。

方法

总共60例接受TAVR治疗的慢性HF患者被随机分为对照组(n = 30)和运动训练(ET)组(n = 30)。对照组接受常规康复治疗,ET组基于心肺运动试验(CPX)给予个性化的运动心脏康复。评估两组的CPX参数、超声心动图、6分钟步行试验距离和生活质量。

结果

所有完成症状限制CPX的患者均未出现并发症。在12周的康复期后,ET组的无氧阈值、峰值摄氧量、峰值氧脉搏、峰值功率、左心室射血分数和6分钟步行试验距离水平均显著高于对照组(P < 0.05)。ET组的明尼苏达心力衰竭生活问卷得分低于对照组(P < 0.05)。

结论

运动心脏康复显著改善了接受TAVR的慢性HF患者的心肺功能、运动耐力和生活质量。

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