Relation of a Maximal Exercise Test to Change in Exercise Tolerance During Cardiac Rehabilitation.
Relation of a Maximal Exercise Test to Change in Exercise Tolerance During Cardiac Rehabilitation.
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DOI：
10.1016/j.amjcard.2022.04.009
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发表时间：
2022-07-15
影响因子：
2.8
通讯作者：
Keteyian, Steven J.
中科院分区：
文献类型：
--
作者：
Brawner, Clinton A.;Pack, Quinn;Berry, Robert;Kerrigan, Dennis J.;Ehrman, Jonathan K.;Keteyian, Steven J.
本研究的目的是检验以下假设：与无GXT相比，基于最大分级运动试验（GXT）的个体化运动训练目标心率（HR）与心脏康复（CR）期间运动耐量的更大改善相关。在这项回顾性研究中，我们确定了2001年至2016年期间完成9-36次CR访视的患者，住院时间≤18周，访视频率为1-3天/周。患者根据他们的运动是否由GXT确定的目标HR指导进行分组。为了评估GXT与运动训练代谢当量（MET）变化之间的关系，我们使用了广义线性模型，该模型根据年龄、性别、种族、转诊原因、CR访视、CR频率、开始时的MET、CR位置和参与年份进行了调整。在4，455例患者（37%女性，48%白色，中位年龄= 62岁）中，53%的患者根据GXT处方了目标HR。与无GXT相比，GXT与CR期间协变量校正MET和自开始的%变化显著更大的增加相关（分别为+0.44 MET [95% CI 0.38，0.51]和+17% [95% CI 14%，19%]）。在一项仅限于≥2天/周访视24-36次的患者（n= 1，319）的敏感性分析中，GXT与协变量校正的运动训练MET显著增加相关（+0.51 [95% CI 0.36，0.66]; +19% [95% CI 13%，24%]）。总之，为了最大限度地提高CR期间的运动能力，患者应接受GXT，以确定个性化的运动训练目标HR。
The purpose of this study was to test the hypothesis that an individualized exercise training target heart rate (HR) based on a maximal graded exercise test (GXT) is associated with greater improvements in exercise tolerance during cardiac rehabilitation (CR) compared to no GXT. In this retrospective study we identified patients who completed 9-36 visits of CR between 2001 and 2016, with a length of stay ≤18 week, and a visit frequency of 1-3 d/week. Patients were grouped based on whether their exercise was guided by a target HR determined from a GXT. To assess the relation between GXT and change in exercise training metabolic equivalents of task (METs), we used generalized linear models adjusted for age, sex, race, referral reason, CR visits, CR frequency, METs at start, CR location, and year of participation. Among 4,455 patients (37% female, 48% White, median age= 62 years), 53% were prescribed a target HR based on a GXT. Compared to no GXT, a GXT was associated with a significantly greater increase in covariate adjusted METs during CR and % change from start (+0.44 METs [95% CI 0.38, 0.51] and +17% [95% CI 14%, 19%], respectively). In a sensitivity analysis limited to patients with 24-36 visits at ≥2 d/week (n= 1,319), a GXT was associated with a significantly greater increase in covariate adjusted exercise training METs (+0.51 [95% CI 0.36, 0.66]; +19% [95% CI 13%, 24%]). In conclusion, to maximize the potential increase in exercise capacity during CR, patients should undergo a GXT to determine an individualized exercise training target HR.
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DOI：
10.1097/hcr.0000000000000337
发表时间：
2018-05-01
影响因子：
3.8
作者：
Squires, Ray W.;Kaminsky, Leonard A.;Williams, Mark A.
通讯作者：
Williams, Mark A.
DOI：
10.1097/00008483-200405000-00008
发表时间：
2004-05-01
期刊：
Journal of cardiopulmonary rehabilitation
影响因子：
--
作者：
Joo, Kee-Chan;Brubaker, Peter H;Whaley, Mitchell H
通讯作者：
Whaley, Mitchell H
影响因子：
4.8
作者：
Keteyian, Steven J.;Kerrigan, Dennis J.;Brawner, Clinton A.
通讯作者：
Brawner, Clinton A.
影响因子：
--
作者：
Pavy, Bruno;Iliou, Marie Christine;Corone, Sonia
通讯作者：
Corone, Sonia
影响因子：
2.7
作者：
Feuerstadt, Paul;Chai, Andrew;Kligfield, Paul
通讯作者：
Kligfield, Paul