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慢性心不全における長期の適度な運動トレーニングのランダム化,制御試験:機能能力,生活の質,臨床結果への影響
R Belardinelli1, D Georgiou, G Cianci
1Servizio di Cardiologia Riabilitativa, Istituto Cardiologico "G.M. Lancisi", Ancona, Italy. R.Bellardinelli@fastnet.it
Circulation
|March 9, 1999
まとめ
長期的な適度な運動トレーニング (ET) は,慢性心不全 (CHF) の患者の機能能力と生活の質を大幅に改善します. この運動介入は,また,心不全による死亡率と再入院を減少させます.
科学分野:
- 心臓病学 心臓病学
- 運動生理学 運動生理学
- リハビリテーション医学 リハビリテーション医学
背景:
- 慢性心不全 (CHF) の治療法としての運動トレーニング (ET) の有効性は,依然として調査中です.
- CHF患者におけるETの利点に関する現在の証拠は議論されています.
研究 の 目的:
- 慢性心筋梗塞の患者における機能能力と生活の質に対する長期的な中程度のETの影響を評価する.
- これらの改善が,減少した死亡率と再入院を含む,より良い臨床結果に転じるか否かを判断する.
主な方法:
- 安定したCHFの患者99人を対象としたランダム化比較試験です.
- 1グループは1年間中程度のET (60%ピークVO2) を受け,対照群は運動しなかった.
- 心肺運動検査,心筋スシンチグラフィー,および生活の質に関するアンケートが評価に使用されました.
主要な成果:
- 運動トレーニングは,ピークVO2 (機能能力) と2ヶ月で生活の質を大幅に改善し,1年後に持続的な利益をもたらしました.
- ET群の患者は,著しく低い死亡率 (RR=0.37) と心不全による再入院 (RR=0.29) を経験しました.
- ベースラインの呼吸器値とトレーニング後のタリウム活性スコアは,臨床イベントの独立した予測指標でした.
結論:
- 長期にわたる適度な運動トレーニングは,CHF患者の機能能力と生活の質の持続的な改善につながります.
- CHF患者におけるETの観察された利点は,好ましい臨床結果に転じ,有害事象を減少させるように見える.
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