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缺血性心脏病患者的心脏康复:对心血管健康和生活质量的益处。

Cardiac rehabilitation for workers with ischemic heart disease: Benefits for cardiovascular health and quality of life.

作者信息

Delgado-Calderón Manuel, Jiménez-Ortega Lara Estefanía, Ladisa María, Camacho-Vega Juan Carlos, Vilches-Arenas Ángel, Luque-Romero Luis Gabriel, Palomo-Gómez Rocío, Martín-Pereira Jorge, Gómez-Salgado Juan

机构信息

Occupational Health Service, Hospital Universitario Virgen Macarena, Sevilla, Spain.

Department of Preventive Medicine, Hospital Universitario Virgen Macarena, Sevilla, Spain.

出版信息

Medicine (Baltimore). 2025 Sep 5;104(36):e44019. doi: 10.1097/MD.0000000000044019.

Abstract

Cardiac rehabilitation programs (CRPs) are multifactorial interventions defined by the World Health Organization as essential strategies to improve patients' health-related quality of life (HRQoL) by enhancing their physical, psychological, social, and occupational well-being. These programs are a cornerstone in the comprehensive treatment of heart disease, facilitating the recovery of functional capacity and reintegration into the workforce through a multidisciplinary approach. The objective of this study was to assess the efficacy of CRPs in enhancing functional capacity (cardiac and psychological) and HRQoL in workers with ischemic heart disease. An observational pre-post study without a control group was conducted, focusing on actively employed individuals with ischemic heart disease. A total of 214 patients were included, selected according to specific inclusion criteria after excluding those not suitable for longitudinal follow-up. Participants were active workers aged 18 to 65 years who were prescribed a CRP between January 2020 and December 2021. Sociodemographic, occupational, cardiovascular risk, and clinical-therapeutic data were collected to evaluate changes following completion of the program. Health-related quality of life (HRQoL) was also assessed. A total of 214 patients were included, 83.9% male, with a mean age of 54.21 years. Most had a history of hypertension, dyslipidemia, smoking, low physical activity, overweight or obesity, and a family history of ischemic heart disease. Among those who started the program (94.4%), the most common diagnosis was acute myocardial infarction involving a single coronary vessel. Additionally, 77.1% underwent stent angioplasty, and 47.2% participated in a moderate-risk CRP. After completion, the SF-36 score improved significantly (46.92 vs 70.21), and depressive symptoms decreased (55.10% vs 38.22%). Significant benefits were observed in most modifiable cardiovascular risk factors, along with an increase in the proportion of patients with preserved left ventricular ejection fraction (65.4% vs 72%) and in metabolic equivalent (MET) levels. In 157 participants (73.4%), MET gain was quantified, with a mean increase of 2.67 ± 1.64 METs. These findings suggest that cardiac rehabilitation, as a secondary prevention strategy, effectively improves cardiac function and HRQoL in working-age patients with ischemic heart disease.

摘要

心脏康复计划(CRPs)是多因素干预措施,世界卫生组织将其定义为通过提高患者的身体、心理、社会和职业幸福感来改善其健康相关生活质量(HRQoL)的重要策略。这些计划是心脏病综合治疗的基石,通过多学科方法促进功能能力的恢复和重新融入劳动力队伍。本研究的目的是评估心脏康复计划对提高缺血性心脏病患者的功能能力(心脏和心理)和健康相关生活质量的疗效。我们进行了一项无对照组的观察性前后研究,重点关注积极就业的缺血性心脏病患者。共纳入214例患者,根据特定纳入标准进行选择,排除那些不适合长期随访的患者。参与者为18至65岁的在职人员,他们在2020年1月至2021年12月期间被开具了心脏康复计划。收集社会人口统计学、职业、心血管风险和临床治疗数据,以评估该计划完成后的变化。还评估了健康相关生活质量(HRQoL)。共纳入214例患者,男性占83.9%,平均年龄为54.21岁。大多数患者有高血压、血脂异常、吸烟、身体活动不足、超重或肥胖病史,以及缺血性心脏病家族史。在开始该计划的患者中(94.4%),最常见的诊断是累及单支冠状动脉的急性心肌梗死。此外,77.1%的患者接受了支架血管成形术,47.2%的患者参加了中度风险的心脏康复计划。完成后,SF-36评分显著提高(46.92对70.21),抑郁症状减少(55.10%对38.22%)。在大多数可改变的心血管危险因素方面观察到显著益处,同时左心室射血分数保留的患者比例增加(65.4%对72%),代谢当量(MET)水平也有所提高。在157名参与者(73.4%)中,对MET增加量进行了量化,平均增加2.67±1.64 METs。这些发现表明,心脏康复作为一种二级预防策略,可有效改善工作年龄缺血性心脏病患者的心脏功能和健康相关生活质量。

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