对心力衰竭和严重功能障碍的老年患者进行心脏康复
Domenico Scrutinio1, Pietro Guida2, Rosa Carbonara1
1Istituti Clinici Scientifici Maugeri SpA SB, IRCCS, Institute of Bari, Bari, Italy.
International journal of cardiology
|October 3, 2024
概括
心脏康复 (CR) 改善了严重功能障碍的老年心力衰竭 (HF) 患者的行走能力. 在CR的功能性收益预测更好的生存率,即使在最老的个体.
科学领域:
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
- 康复医学 康复医学 康复医学
背景情况:
- 对于严重功能障碍的老年心力衰竭 (HF) 患者,心脏康复 (CR) 的好处尚未得到充分证实.
- 在HF中,严重的功能障碍往往是由6分钟的步行距离 (6MWD) 定义的.
研究的目的:
- 评估CR在改善老年患者HF和严重功能障碍的功能能力方面的有效性.
- 评估CR后功能改善与三年死亡率之间的关联.
主要方法:
- 分析了一组1397名患有HF和严重功能障碍 (6MWD <300 m) 的住院CR患者.
- 患者被分为三个年龄组:年轻 (≤65岁),老年 (66-75岁) 和老年 (>75岁).
- 使用多变量Cox建模来确定实现6MWD≥300 m对三年死亡率的影响.
主要成果:
- 所有年龄段的大量患者最初无法无助行走.
- 虽然独立行走的能力在各组中得到了相当大的百分比,但实现主要结果 (6MWD ≥300 m) 根据年龄组有很大差异 (49.1%的年轻人,32.2%的老年人,15.7%的老年人).
- 实现主要结果与所有年龄组,包括老年人,三年死亡风险降低有关 (调整后的HR为0.68).
结论:
- 心脏康复为老年心力衰竭患者带有严重功能障碍提供了好处.
- 通过CR实现的功能改善是该患者群体中改善生存率的重要预测因素.
- 即使是患有严重功能障碍的最年长的患者 (>75岁) 也可以从CR中受益,功能收益与更好的长期结果有关.
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