CPET指导下心脏康复治疗对老年冠心病HFpEF患者心肺功能运动耐量及生活质量的影响

doi:10.3969/j.issn.1006-6233.2024.08.016

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Abstract Objective: To explore the effects of cardiopulmonary exercise testing (CPET)-guided cardiac rehabilitation on cardiorespiratory function, exercise tolerance, and quality of life in elderly patients with coronary heart disease (CHD) and heart failure with preserved ejection fraction (HFpEF).Methods: A retrospective analysis was conducted on the clinical data of 103 elderly patients with coronary heart disease and HFpEF admitted to Kunming Second People's Hospital from June 2020 to May 2022. Patients were divided into two groups: the control group (51 cases) and the observation group (52 cases). The control group received conventional symptomatic treatment, while the observation group received CPET-guided cardiac rehabilitation in addition to the conventional treatment for 12 weeks. Changes in cardiorespiratory function [anaerobic threshold (AT), peak oxygen consumption (VO₂ peak), exercise duration (ED), and ventilatory equivalent for carbon dioxide slope (VE/VCO₂ slope)], myocardial enzyme levels [creatine kinase-MB (CK-MB), creatine kinase (CK), and lactate dehydrogenase (LDH)], N-terminal pro-brain natriuretic peptide (NT-proBNP), exercise tolerance [6-minute walk test (6 MWT)], Minnesota Living with Heart Failure Questionnaire (LHFQ) scores, and prognosis (1-year readmission rate and 1-year mortality rate) were compared before and after treatment.Results: After treatment, the observation group showed significantly higher AT 14.65±2.03mL·kg^-1·min^-1, VO₂ peak mL·kg^-1·min^-1, and ED [(436.89±46.85) s] compared to the control group (11.24±1.95)mL·kg^-1·min^-1,(21.65±2.49)mL·kg^-1·min^-1, and (378.46±46.18)s, respectively. The VE/VCO₂ slope in the observation group (30.27±2.75)mmoL/L was lower than in the control group (35.05±2.80)mmoL/L, with statistically significant differences (P<0.05). The observation group also had lower levels of CK-MB (136.84±24.35) IU/L, CK (28.48±4.29)IU/L, LDH (26.48±5.85)IU/L, and NT-proBNP (1535.25±32.09)pg/mL compared to the control group (325.45±35.48)IU/L, (56.26±5.84) IU/L, (49.32±6.88)IU/L, and (1716.73±39.42)pg/mL respectively, with statistically significant differences (P<0.05). The 6 MWT in the observation group [(405.46±52.28) m] was greater than in the control group [(345.19±48.64) m], with a statistically significant difference (P<0.05). LHFQ scores for emotional, physical, and other domains, as well as the total score, were significantly lower in the observation group [(8.26±1.95) points, (22.49±3.68) points, (21.58±3.39) points, and (56.29±5.39) points] compared to the control group [(11.38±2.26) points, (25.55±3.80) points, (24.68±3.97) points, and (63.45±6.98) points], with statistically significant differences (P<0.05). The 1-year readmission rate and 1-year mortality rate in the observation group were 15.38% and 5.77%, respectively, compared to 31.37% and 15.69% in the control group, with no statistically significant difference (P>0.05).Conclusion: CPET-guided cardiac rehabilitation can suppress myocardial enzyme levels, improve cardiorespiratory function, and enhance exercise tolerance and quality of life in elderly patients with coronary heart disease and HFpEF.

Key words： Coronary heart disease Heart failure Cardiac rehabilitation Cardiopulmonary exercise test Cardiopulmonary function Exercise tolerance

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2024.08.016 OR http://www.hbyxzzs.cn/EN/Y2024/V30/I8/1319

[1] Rush CJ,Berry C,Oldroyd KG,et al.Prevalence of coronary artery disease and coronary microvascular dysfunction in patients with heart failure with preserved ejection fraction[J].JAMA Cardiol,2021,6(10):1130-1143.
[2] Heidenreich PA,Bozkurt B,Aguilar D,et al.2022 AHA/ACC/HFSA guideline for the management of heart failure:executive summary:a report of the American college of cardiology/American heart association joint committee on clinical practice guidelines[J].Circulation,2022,145(18):e876-e894.
[3] Patti A,Merlo L,Ambrosetti M,et al.Exercise-based cardiac rehabilitation programs in heart failure patients[J].Heart Fail Clin,2021,17(2):263-271.
[4] 王志燕,陈晨,吕强,等.2021年ESC急慢性心力衰竭诊断与治疗指南解读[J].中华心血管病杂志,2021,49(12):1252-1255.
[5] Bozkurt B,Fonarow GC,Goldberg LR,et al.Cardiac rehabilitation for patients with heart failure:JACC expert panel[J].Am Coll Cardiol,2021,77(11):1454-1469.
[6] Ponikowski P,Voors AA,Anker SD,et al.2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure:The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European society of cardiology (ESC)developed with the special contribution of the heart failure association (HFA) of the ESC[J].Eur Heart,2016,37(27):2129-2200.
[7] 郭瑞霞,冯永萌,姚琦,等.渐进式康复运动对急性心肌梗死后心力衰竭病人氧化应激指标及运动耐量的影响[J].中西医结合心脑血管病杂志,2021,19(20):3543-3545.
[8] Kitzman DW,Whellan DJ,Duncan P,et al.Physical rehabilitation for older patients hospitalized for heart failure[J].N Engl Med,2021,385(3):203-216.
[9] 雷翔梨,郭文玲.心肺运动试验在冠心病治疗及康复中的研究进展[J].中西医结合心脑血管病杂志,2023,21(2):290-292.
[10] 罗新林,徐验.心肺运动试验在心力衰竭患者中的应用及进展[J].岭南心血管病杂志,2021,27(1):115-118.
[11] Leggio M,Fusco A,Loreti C,et al.Effects of exercise training in heart failure with preserved ejection fraction:an updated systematic literature review[J].Heart Fail Rev,2020,25(5):703-711.
[12] 马骋宇,惠怡华,白春林.运动康复干预射血分数保留型心力衰竭的研究进展[J].中西医结合心脑血管病杂志,2022,20(3):480-484.
[13] Xiong YZ,Luan YS,Zhang B,et al.Morphological study of the effect of aerobic exercise on organs and arteries in spontaneously hypertensive Rats[J].Healthcare (Basel),2021,9(8):1066.
[14] 黄红梅,胡宗祥,刘昭强,等.长期高强度间歇训练加重自发性高血压大鼠心肌纤维化[J].中国运动医学杂志,2020,39(8):615-625.
[15] 刘海燕,李良,王莎莎,等.心肺运动测试指导心脏康复联合正念认知疗法对老年慢性心力衰竭患者心肺功能、焦虑抑郁情绪和预后的影响[J].现代生物医学进展,2022,22(10):1851-1855.