在接受β-上腺阻塞治疗的患者中,使用测量 (而不是预测) 的最大心率来计算心脏康复的目标心率
Steven J Keteyian1, Katherina Steenson, Crystal Grimshaw
1Division of Cardiovascular Medicine, Henry Ford Health, Detroit, Michigan (Drs Keteyian, Kerrigan, Ehrman, and Brawner, Mss Steenson, Grimshaw, and Koester-Qualters, and Messrs Mandel and Berry); and Department of Public Health Sciences, Henry Ford Health, Detroit, Michigan (Dr Peterson).
Journal of cardiopulmonary rehabilitation and prevention
|June 13, 2023
概括
使用预测最大心率 (HR max) 或静止心率 (HR) 的目标心率 (THR) 计算与心脏康复 (CR) 患者的指导方针建议不一致. 这影响有效恢复的运动强度处方.
科学领域:
- 心脏病学 心脏病学
- 运动生理学 运动生理学
- 康复医学 康复医学 康复医学
背景情况:
- 对于从心脏事件中恢复过来的患者来说,心脏康复 (CR) 非常重要.
- 在CR患者中,β-上腺阻塞 (βB) 治疗是常见的,影响心率反应.
- 准确的目标心率 (THR) 处方对于优化CR期间的运动强度至关重要.
研究的目的:
- 评估使用预测最大心率 (HR max) 计算的THR与在βB治疗中接受CR的患者中测量HR max之间的一致性.
- 与心率储备 (HR储备) 方法相比,在使用各种预测方法时评估符合指南的THR值的频率.
主要方法:
- 接受βB治疗的CR患者接受了心肺运动测试,以确定测量HRmax.
- 预测HRmax是使用220年龄公式和特定疾病方程计算的.
- 使用HR储备方法预测和测量HRmax,直线百分比和静止HR增量 (+20,+30 bpm) 来计算THR.
主要成果:
- 预测HRmax值与测量HRmax值显著不同 (P < .001).
- 从预测HRmax计算的THR很少落在指导方针建议的测量HR储备的50-80%.
- 使用休息HR+20或+30 bpm导致大量患者的运动量低于HR储备的50%.
结论:
- 根据预测HRmax或简单的休息HR增量得出的THR来规定运动强度通常与CR指南不一致.
- 目前的预测方法可能会导致βB治疗患者的运动强度低于最佳.
- 准确的HRmax测量对于CR程序中适当的THR设置至关重要.
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