经导管主动脉瓣置换术（TAVR）后患者心肺功能微创干预的长期疗效及安全性——ENERGY研究的延长随访

Long term efficacy and safety of MICT of cardiopulmonary function in patients after TAVR extended follow up of ENERGY study.

作者信息

Li Yu-Shan, Ren Qiang, Mu Xing-Bo, Xu Kai, Liang Yan-Chun, Zhang Jian, Wang Geng, Wang Yan-Xia, Wang Cai-Lian, Zhang Yi, Wang Sheng-Yi, Zhang Quan-Yu, Han Ya-Ling

机构信息

State Key Laboratory of Frigid Zone Cardiovascular Diseases (SKLFZCD), Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, China.

Department of Cardiology, General Hospital of Northern Theater Command Training Base for Graduate, Dalian Medical University, Dalian, China.

出版信息

Sci Rep. 2025 Aug 4;15(1):28344. doi: 10.1038/s41598-025-13451-z.

DOI:10.1038/s41598-025-13451-z

PMID:40760006

Abstract

The ENERGY study demonstrated that 3-month moderate-intensity continuous training (MICT) improved the cardiopulmonary function and exercise capacity for patients after transcatheter aortic valve replacement (TAVR). However, the long-term effects remained uncertain. Therefore, the present study evaluated the long-term efficacy and safety of MICT in patients undergoing TAVR. 64 patients were randomized into MICT (3 times per week) or control groups (one-time physical activity advice). Outcomes were assessed using the 12-month changes in cardiopulmonary exercise testing (CPET) parameters, 6-minute walk test (6MWT), SF-12 quality of life score, New York Heart Association (NYHA) class, echocardiographic and laboratory parameters. After 12 months, the MICT group showed significantly greater improvements in peak VO (1.61 ml/kg/min, 95% CI 0.10 to 3.12, P = 0.037), peak MET (0.56, 95% CI 0.20 to 0.93, P = 0.003), VOAT (1.55 ml/kg/min, 95% CI 0.80 to 2.30, P < 0.001), METAT (0.35, 95% CI 0.10 to 0.61, P = 0.007), peak O pulse (1.04 mL/beat, 95% CI 0.03 to 2.05, P = 0.044), 6MWT (21.24 m, 95% CI 7.10 to 35.39, P = 0.004), and mental component summary of SF-12 (10.47, 95% CI 0.48 to 20.45, P = 0.040) compared to control group. Long-term MICT safely and effectively enhances the cardiopulmonary function and quality of life in patients after TAVR.

摘要

“能量”研究表明，3个月的中等强度持续训练（MICT）可改善经导管主动脉瓣置换术（TAVR）后患者的心肺功能和运动能力。然而，长期效果仍不确定。因此，本研究评估了MICT对接受TAVR患者的长期疗效和安全性。64例患者被随机分为MICT组（每周3次）或对照组（一次性身体活动建议）。使用心肺运动试验（CPET）参数、6分钟步行试验（6MWT）、SF-12生活质量评分、纽约心脏协会（NYHA）分级、超声心动图和实验室参数的12个月变化来评估结果。12个月后，与对照组相比，MICT组在峰值VO（1.61 ml/kg/min，95%CI 0.10至3.12，P = 0.037）、峰值代谢当量（0.56，95%CI 0.20至0.93，P = 0.003）、VOAT（1.55 ml/kg/min，95%CI 0.80至2.30，P < 0.001）、METAT（0.35，95%CI 0.10至0.61，P = 0.007）、峰值氧脉搏（1.04 mL/次搏动，95%CI 0.03至2.05，P = 0.044）、6MWT（21.24 m，95%CI 7.10至35.39，P = 0.004）和SF-12精神成分总结（10.47，95%CI 0.48至20.45，P = 0.040）方面有显著更大的改善。长期MICT可安全有效地增强TAVR术后患者的心肺功能和生活质量。