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经导管主动脉瓣置入术患者的心脏康复:安全性与益处:一篇叙述性综述

Cardiac Rehabilitation in TAVI Patients: Safety and Benefits: A Narrative Review.

作者信息

Stamate Theodor Constantin, Adam Cristina Andreea, Gavril Radu Sebastian, Miftode Radu Ștefan, Rotundu Andreea, Mitu Ovidiu, Cojocaru Doina Clementina, Tinică Grigore, Mitu Florin

机构信息

Department of Medical Specialties I, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.

Doctoral School, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.

出版信息

Medicina (Kaunas). 2025 Apr 1;61(4):648. doi: 10.3390/medicina61040648.

Abstract

Transcatheter aortic valve implantation (TAVI) has redefined the management of severe aortic stenosis, particularly in surgical high-risk patients. As the number of TAVI procedures increases, there is a growing need for effective post-procedural care. Cardiac rehabilitation (CR) has emerged as a critical component of treatment in these patients. The most recent update of the European recommendations highlights the importance of including post-TAVI patients in CR programs. However, the benefits of CR in this particular patient group still need to be fully understood. The objective of this narrative review is to summarize the safety and benefits of post-TAVI CR by evaluating its impact on functional capacity, frailty, muscular strength, mental health, quality of life, and long-term survival. While emerging evidence supports its safety and effectiveness in the aforementioned outcomes, gaps remain regarding the optimal rehabilitation protocols, including the timing, duration, and intensity of CR as well as its long-term cardiovascular benefits. Further research is needed to develop personalized approaches for different patient groups. This article highlights the current knowledge, identifies critical gaps, and underlines the need for tailored rehabilitation strategies to improve post-TAVI recovery and patient outcomes.

摘要

经导管主动脉瓣植入术(TAVI)重新定义了重度主动脉瓣狭窄的治疗方式,尤其是对于手术高危患者。随着TAVI手术数量的增加,术后有效护理的需求日益增长。心脏康复(CR)已成为这些患者治疗的关键组成部分。欧洲建议的最新更新强调了将TAVI术后患者纳入CR计划的重要性。然而,CR对这一特定患者群体的益处仍有待充分了解。本叙述性综述的目的是通过评估其对功能能力、虚弱程度、肌肉力量、心理健康、生活质量和长期生存的影响,总结TAVI术后CR的安全性和益处。虽然新出现的证据支持其在上述结局方面的安全性和有效性,但在最佳康复方案方面仍存在差距,包括CR的时机、持续时间和强度及其长期心血管益处。需要进一步研究为不同患者群体制定个性化方法。本文强调了当前的知识,确定了关键差距,并强调了需要制定量身定制的康复策略以改善TAVI术后恢复和患者结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d7d/12028665/6f4fdc325949/medicina-61-00648-g001.jpg

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