Effects of the HEART Camp Trial on Adherence to Exercise in Patients With Heart Failure
Effects of the HEART Camp Trial on Adherence to Exercise in Patients With Heart Failure
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DOI：
10.1016/j.cardfail.2018.06.007
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发表时间：
2018-10-01
影响因子：
6
通讯作者：
Keteyian, Steven J.
中科院分区：
文献类型：
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作者：
Pozehl, Bunny J.;McGuire, Rita;Keteyian, Steven J.
背景资料：在心力衰竭（HF）患者中，很少有运动训练研究报告坚持指南推荐的每周150分钟中等强度运动，也没有研究关注坚持的主要结局。方法和结果：这项随机对照试验评估了多组分干预，心力衰竭运动和阻力训练营（HEART）对坚持运动的影响。（6、12和18个月后）与增强常规护理（EUC）组相比。患者（n = 204）中55.4%为男性，总体平均年龄为60.4岁，47.5%为非白人。HEART Camp组在12个月（42%）和18个月（35%）时的依从性显著高于EUC组（分别为28%和19%）。6个月时无显著性差异（P > 0.05）。根据患者的年龄、种族、性别、婚姻状况、HF类型（射血分数保留或降低）或纽约心脏协会功能分级，治疗效果无差异。左心室射血分数（LVEF）显着缓和的治疗效果，更大的坚持在更高的LVEF.Conclusions：多组分的心脏营干预显示出显着的效果，在12个月和18个月的疗效。坚持水平仍然适中，表明需要更多的研究来解决方法和策略，以促进HF患者坚持运动。
Background: Few exercise training studies in patients with heart failure (HF) report adherence to guideline-recommended 150 minutes of moderate-intensity exercise per week, and no studies have focused on a primary outcome of adherence.Methods and Results: This randomized controlled trial evaluated the effect of a multicomponent intervention, Heart Failure Exercise and Resistance Training (HEART) Camp, on adherence to exercise (after 6, 12, and 18 months) compared with an enhanced usual care (EUC) group. Patients (n = 204) were 55.4% male, overall average age was 60.4 years, and 47.5% were nonwhite. The HEART Camp group had significantly greater adherence at 12 (42%) and 18 (35%) months compared with the EUC group (28% and 19%, respectively). No significant difference (P > .05) was found at 6 months. The treatment effect did not differ based on patient's age, race, gender, marital status, type of HF (preserved or reduced ejection fraction) or New York Heart Association functional class. Left ventricular ejection fraction (LVEF) significantly moderated the treatment effect, with greater adherence at higher LVEF.Conclusions: The multicomponent HEART Camp intervention showed efficacy with significant effects at 12 months and 18 months. Adherence levels remained modest, indicating a need for additional research to address methods and strategies to promote adherence to exercise in patients with HF.