患有晚期心力衰竭和左心室辅助器件的患者进行监督运动训练:多中心随机对照试验 (Ex-VAD试验)
Anna Feuerstein1,2,3, Felix Schoenrath2,3,4, Evgeny Belyavskiy1,2,5
1Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité (DHZC) - Medical Heart Center of Charité and German Heart Institute Berlin, Berlin, Germany.
European journal of heart failure
|September 13, 2023
概括
在使用左心室辅助装置 (LVAD) 的高级心力衰竭患者的监督运动训练没有改善峰值氧气消耗. 然而,它对子最大运动能力和生活质量产生了积极的影响.
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:
- 带有左心室辅助装置 (LVAD) 的高级心力衰竭患者经常经历有限的运动能力.
- 之前的研究表明,运动训练对该人群的氧气消耗峰值 (VO2峰值) 有潜在的益处.
研究的目的:
- 评估监督运动训练在改善晚期心力衰竭和LVAD患者的运动能力方面的有效性.
- 评估运动对VO2峰值,亚最大运动能力和生活质量的影响.
主要方法:
- 一个多中心,前性,随机对照试验,涉及64名心力衰竭和LVAD稳定的患者.
- 患者被随机分配 (2:1) 到12周的监督运动训练或常规护理.
- 主要终点是VO2峰值的变化;次要终点包括6分钟的步行距离和生活质量.
主要成果:
- 运动训练并没有显著改善VO2峰值 (平均差异为0.826毫升/分钟/公斤,p=0.183).
- 在6分钟的步行距离 (43.4米增加,p=0.0024) 和身体生活质量 (堪萨斯市心肌病问卷,p=0.0124) 中观察到显著改善.
- 很高的坚持 (71%) 和没有显著的差异在不良事件之间的群体.
结论:
- 经过12周的监督运动训练并没有提高LVAD心力衰竭患者的峰值氧气消耗.
- 在这个患者群体中,运动训练对亚最大运动能力和身体生活质量产生积极影响.
- 监督运动可以被认为是改善LVAD患者功能状态的安全和有益的干预措施.
更多相关视频
12:45Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
Published on: December 11, 2017
10.5K
04:20Integration of Brain Tissue Saturation Monitoring in Cardiopulmonary Exercise Testing in Patients with Heart Failure
Published on: October 1, 2019
5.8K
相关概念视频
01:22Heart Failure VI: Adjunct Therapies
16
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
16
01:30Heart Failure V: Medical Management
12
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
12
01:29Cardiomyopathy V: Interprofessional Care
14
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
14
01:30Heart Failure VII: Nursing Interventions
90
The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
90
01:26Heart Failure Drugs: Inotropic Agents
617
Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
617
01:27Heart Failure I: Introduction
14
Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
14