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心率波动对稳定型冠状动脉疾病患者有氧训练结果的影响:一项前瞻性研究。

Effects of Heart Rate Fluctuation on Aerobic Training Outcomes in Patients With Stable Coronary Artery Disease: A Prospective Study.

作者信息

Liu Jun Hong, Song Hui Hui, Zhang Hua Fang, Ji Jia Lin, Zhou Xue Jiao, Sun Xi Cai

机构信息

The Third Department of Geriatrics, Weifang People's Hospital, Weifang 261042, Shandong, China.

Obstetrics and Gynecology Medical Center, Weifang People's Hospital, Weifang 261042, Shandong, China.

出版信息

Cardiol Res. 2024 Dec;15(6):460-466. doi: 10.14740/cr1710. Epub 2024 Nov 8.

Abstract

BACKGROUND

This study aimed to evaluate the effects of different heart rate fluctuation ranges during aerobic training on outcomes in patients with stable coronary artery disease (CAD).

METHODS

Ninety-seven patients diagnosed with stable CAD were enrolled between March 2017 and December 2019. Participants were randomly assigned to three groups: the control (CON) group, the medium-intensity heart rate small range (MIS) group, and the medium-intensity heart rate large range (MIL) group. The CON group received standard care and patient education, while the MIS and MIL groups underwent personalized rehabilitation training with specific heart rate fluctuation targeted ranges, in addition to standard care. Cardiopulmonary function and exercise performances were assessed using resting heart rate (RHR), maximum heart rate (HRmax), heart rate recovery (HRR), and a 6-min walk test (6MWT) at the baseline and after 16 weeks of training.

RESULTS

The MIS group demonstrated a significant reduction in RHR compared to the CON and MIL groups. While both exercise rehabilitation groups exhibited improvement in HRR, only the MIS group achieved a statistically significant improvement compared to the CON group. Post-training HRmax and 6MWT performance increased in both MIS and MIL groups, with only the MIL group presenting statistical significance compared to the CON group.

CONCLUSION

Exercise rehabilitation with different training regimens can enhance cardiac function in patients with CAD. Different heart rate modulation strategies yielded distinct effects on cardiopulmonary function. Maintenance of a narrower heart rate fluctuation during exercise was observed to significantly enhance the effectiveness of rehabilitation, which could lead to new treatment protocols or optimization of existing strategies for patients with cardiovascular conditions. The combination of 6MWT and power bicycle training may offer an effective method for improving cardiac function in community-based rehabilitation settings.

摘要

背景

本研究旨在评估有氧运动训练期间不同心率波动范围对稳定型冠状动脉疾病(CAD)患者预后的影响。

方法

2017年3月至2019年12月期间纳入了97例诊断为稳定型CAD的患者。参与者被随机分为三组:对照组(CON)、中等强度心率小范围组(MIS)和中等强度心率大范围组(MIL)。CON组接受标准护理和患者教育,而MIS组和MIL组除接受标准护理外,还进行了具有特定心率波动目标范围的个性化康复训练。在基线和训练16周后,使用静息心率(RHR)、最大心率(HRmax)、心率恢复(HRR)和6分钟步行试验(6MWT)评估心肺功能和运动表现。

结果

与CON组和MIL组相比,MIS组的RHR显著降低。虽然两个运动康复组的HRR均有所改善,但只有MIS组与CON组相比有统计学意义上的显著改善。MIS组和MIL组训练后的HRmax和6MWT表现均有所提高,只有MIL组与CON组相比有统计学意义。

结论

不同训练方案的运动康复可增强CAD患者的心脏功能。不同的心率调节策略对心肺功能产生不同的影响。观察到运动期间维持较窄的心率波动可显著提高康复效果,这可能会为心血管疾病患者带来新的治疗方案或优化现有策略。6MWT和功率自行车训练相结合可能为社区康复环境中改善心脏功能提供一种有效方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa3a/11650570/c19eac0f1efa/cr-15-460-g001.jpg

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