Age-Related Differences for Cardiorespiratory Fitness Improvement in Patients Undergoing Cardiac Rehabilitation.
Age-Related Differences for Cardiorespiratory Fitness Improvement in Patients Undergoing Cardiac Rehabilitation.
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DOI：
10.3389/fcvm.2022.872757
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发表时间：
2022
影响因子：
3.6
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中科院分区：
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我们研究了心脏康复（CR）期间运动训练对峰值摄氧量（峰值VO2）改善的年龄相关差异。这是一项梅奥诊所罗切斯特CR项目的回顾性队列研究，纳入了1999年至2017年期间参加CR（≥1次）的任何符合条件的成年患者，并在CR前后进行了心肺运动试验，并获得了VO2数据（峰值呼吸交换比≥1.0）。使用方差分析比较年轻人（20-49岁）、中年人（50-64岁）和老年人（≥65岁）的峰值耗氧量增量和百分比变化；和峰值VO2响应者的百分比（> %变化）。708例患者（年龄：60.8±12.1岁，女性24%）符合纳入标准。老年人的峰值VO2 δ和百分比变化（1.6±3.2 mL.kg.min - 1; 12±27%）低于年轻人（3.7±4.0 mL.kg）。Min−1,p < 0.001；（23±28%,p = 0.002），中年人（2.8±3.8 mL.kg）。Min−1,p < 0.001；（17±28%,p = 0.04）。中年人与年轻人相比，峰值VO2的δ变化显著降低（p = 0.02），但没有百分比变化。应答者百分比仅在老年人和年轻人之间存在差异（72% vs. 86%; p = 0.008）。非手术患者的敏感性分析显示，δ变化的差异相似，老年人和年轻人之间变化百分比的差异仍然显著（10±20% vs. 16±18%;p = 0.04）。在CR患者中，老年人心肺健康的改善程度低于年轻人和中年人。虽然排除手术患者可以减少年龄相关差异，但老年人在CR期间心肺功能改善程度仍较低。这些发现可能对老年人个性化CR规划以降低未来心血管风险具有指导意义。
We investigated age-related differences for peak oxygen uptake (peak VO2) improvement with exercise training during cardiac rehabilitation (CR). This was a retrospective cohort study of the Mayo Clinic Rochester CR program including adult patients who attended CR (≥1 session) for any eligible indication between 1999 and 2017 and who had a cardiopulmonary exercise test pre and post CR with VO2 data (peak respiratory exchange ratio ≥1.0). Younger (20–49 yrs), midlife (50–64 yrs), and older adults (≥65 yrs) were compared using ANOVA for delta and percent change in peak VO2; and percentage of peak VO2 responders (>0% change). 708 patients (age: 60.8 ± 12.1 years; 24% female) met inclusion criteria. Delta and percent change in peak VO2 was lower for older adults (1.6 ± 3.2 mL.kg.min−1; 12 ± 27%) compared with younger (3.7 ± 4.0 mL.kg.min−1, p < 0.001; 23 ± 28%, p = 0.002) and midlife adults (2.8 ± 3.8 mL.kg.min−1, p < 0.001; 17 ± 28%, p = 0.04). For midlife, delta change, but not percent change in peak VO2 was significantly lower (p = 0.02) compared with younger. Percentage of responders was only different between older and younger (72 vs. 86%; p = 0.008). Sensitivity analyses in non-surgical patients showed similar differences for delta change, and differences in percent change remained significant between older and younger adults (10 ± 20% vs. 16 ± 18%; p = 0.04). In CR patients, older adults had lower improvement in cardiorespiratory fitness than younger and midlife adults. While excluding surgical patients reduced age-related differences, older adults still had lower cardiorespiratory fitness improvement during CR. These findings may have implications for individualizing CR programming in aging populations to reduce future cardiovascular risk.