无声心肌缺血:基于运动的心脏康复的安全性和有效性
Javier Loureiro Diaz1, Amine Ghram2, Praveen Jayaprabha Surendran3
1Javier Loureiro Diaz, MSc, ACSM-CEP, Clinical Exercise Physiology Specialist, Department of Physical Education and Sport, Faculty of Sports Sciences and Physical Education, Universidade da Coruña, Performance and Health Group, Oleiros, Spain, and Cardiac Rehabilitation Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
心脏康复 (CR) 在患有无声心肌缺血症 (SMI) 的患者中显著改善运动能力和缺血耐受性. 这种安全有效的干预措施提高了高风险冠心病患者的治疗结果.
科学领域:
- 心脏病学 心脏病学
- 运动生理学 运动生理学
背景情况:
- 无声心肌缺血 (Silent myocardial ischemia,SMI) 是冠状动脉疾病 (CAD) 的不良结果的一个预测因素.
- 心脏康复 (CR) 对SMI患者的影响已被有限地研究.
- 本研究研究了CR对SMI患者的运动能力,缺血门和安全性的影响.
研究的目的:
- 评估基于运动的CR对SMI患者的峰值运动能力和缺血值的影响.
- 为了评估训练工作量进展,药物坚持和抑郁症得分的变化.
- 确定SMI患者在CR期间运动相关不良事件的发生率.
主要方法:
- 对966名被引用到CR的患者进行了回顾性队列研究.
- 最终分析包括29名SMI (I型和II型) 患者和有效的运动前/运动后测试.
- 双对t测试用于分析峰值运动能力和缺血值的变化.
主要成果:
- CR显著提高了峰值运动能力 (MET峰值:8.43至9.14,P<.001).
- 缺血值显示显著改善:心率增加 (P <.001),缩血压降低 (P =.006),速度-压力产物增加 (P =.009).
- 不良事件很少发生 (每100次会议2.23),没有重大事件. 药物适应性仍然很高 (>85%).
结论:
- 基于运动的CR对于SMI患者来说是安全有效的.
- 在SMI患者中,CR提高了运动能力和缺血性耐受性,副作用最小.
- 研究结果支持对无症状,高风险冠状动脉患者进行CR整合.
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