心房細動の患者における運動訓練の効果 潜在的緩和要因を考慮して: 体系的レビューとメタ解析
Agustín Manresa-Rocamora1,2, Laura Fuertes-Kenneally3,4, Noemí Sempere-Ruiz1,2
1Institute for Health and Biomedical Research of Alicante (ISABIAL), Alicante, 03010, Spain.
Sports medicine - open
|August 23, 2025
まとめ
運動は心房細動 (AF) の患者で酸素のピークを改善します. 適度な強度の運動は永久性AFの休息時の心拍数を低下させる可能性がありますが,AFの負担と症状に関するさらなる研究が必要です.
科学分野:
- 心臓病科
- スポーツ医学
- 運動 生理学
背景:
- 運動による心臓リハビリテーション (CR) は,心房細動 (AF) の患者にとって有望である.
- 過去の証拠は有益な影響を示唆していますが,研究ではAFのタイプとトレーニングの変数による差異が欠如しています.
- 運動の形態や強度が 結果に与える具体的な影響は不明である.
研究 の 目的:
- 運動能力,生活の質 (QoL),休息時の心拍数 (HR),AFの負担,およびAF患者の症状に対するエアロビック,レジスタンス,および結合運動の効果を評価する.
- AFのタイプと運動の変数に基づいて効果を区別する.
主な方法:
- 2025年5月までPubMed,Embase,Web of Scienceで電子検索を行った.
- 標準化された平均差 (SMD) または平均差 (MD) を制御および複数介入試験で推定する.
- ランダム効果モデルを用いた効果サイズ指数と,AF型に基づくサブグループ分析を行った.
主要な成果:
- エアロビック運動は AFのタイプに関係なくピーク酸素吸収 (VO2ピーク) を著しく改善します (MD = 4. 24 ml/kg/min).
- アエロビック運動は非常時性AFでは休息時のHRを低下させたが,常時性AFではそうではない.
- 通常のケアと比較して,QOLと6分歩行テスト (6MWT) の改善において,有意な差異は認められなかった.
結論:
- エアロビック運動は,永久的および非永久的なAF患者において,VO2ピークを高めます.
- 適度な強度の運動 (MIE) は恒常的なAFでは休息時のHRを低下させるが,非恒常的なAFではその効果は観察されなかった.
- AFの負担と症状に対するCRの影響に関する証拠は限られているが,さらなる研究が必要である.
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