河北医学2024，Vol.30Issue(8)：1319-1326,8.DOI:10.3969/j.issn.1006-6233.2024.08.016
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
Impact of Cardiopulmonary Exercise Testing-Guided Cardiac Rehabilitation on Cardiorespiratory Function Exercise Tolerance and Quality of Life in Elderly Patients with CHD and HFpEF
摘要
Abstract
Objective:To explore the effects of cardiopulmonary exercise testing(CPET)-guided cardi-ac 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 retro-spective analysis was conducted on the clinical data of 103 elderly patients with coronary heart disease and HF-pEF 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 Question-naire(LHFQ)scores,and prognosis(1-year readmission rate and 1-year mortality rate)were compared be-fore 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 con-trol 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,re-spectively.The VE/VCO2 slope in the observation group(30.27±2.75)mmoL/L was lower than in the con-trol 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 signifi-cant 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 observa-tion 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 readmis-sion 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).Conclu-sion: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.关键词
冠心病/心力衰竭/心脏康复/心肺运动测试/心肺功能/运动耐量Key words
Coronary heart disease/Heart failure/Cardiac rehabilitation/Cardiopulmonary ex-ercise test/Cardiopulmonary function/Exercise tolerance引用本文复制引用
张云珊,钱佳丽,陈秀丽,王旋,张永调,刘福琳,李结赛,张铨..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[J].河北医学,2024,30(8):1319-1326,8.基金项目
昆明市卫生科技人才培养项目医学科技学科后备人才(千工程)培养计划,[编号:2023-SW(后备)-74] （千工程）
