Disparate effects of improving aerobic exercise capacity and quality of life after cardiac rehabilitation in young and elderly coronary patients.
Disparate effects of improving aerobic exercise capacity and quality of life after cardiac rehabilitation in young and elderly coronary patients.
复制标题
DOI：
10.1097/00008483-200007000-00004
复制
发表时间：
2000-07-01
期刊：
影响因子：
--
通讯作者：
Milani, R V
中科院分区：
文献类型：
--
作者：
Lavie, C J;Milani, R V
目的：尽管心肺运动变量可预测冠心病患者的预后、功能容量和生活质量，但这些变量在老年冠心病患者运动训练前后尚未得到充分评估。方法：作者分析了在第二阶段心脏康复和运动训练计划前后连续的患者，并比较了125名年轻患者(55岁；平均48+/-6岁)和57名老年人(>；70岁；平均78+/-3年)的运动心肺数据和有效问卷的数据。最大耗氧量(VO2)(-19%；P<；0.001)，无氧阈值(-10%；P<；0.05)，总功能评分(-11%；P<；0.01)和总生活质量评分(-5%；P=0.06)。与运动训练前(年轻患者和老年患者分别为+23%和+12%)和运动训练后(年轻患者和老年患者分别为+51%和+31%)的心肺测试精确测量相比，常用的预测公式大大高估了有氧运动能力，而且与老年患者相比，年轻患者的情况更严重。康复后，老年人在有氧运动量(+32%；P<；0.0001)、最大摄氧量(+13%；P<；0.0001)、无氧阈值(+11%；P=0.03)、总功能评分(+27%；P<；0.0001)和总生活质量评分(+20%；P<；0.0001)方面有显著改善。尽管年轻患者在估计有氧运动量(+44%比+32%；P=0.08)、峰值VO2(+18%比+13%；P<；0.01)和无氧阈值(+17%比+11%；P=0.07)方面有更大的改善，但老年人在这两个功能评分(+27%比+20%；P=0.02)和总生活质量评分(+20%比+14%；P=0.03)方面都有更大的改善。结论：这些数据证实了通过心肺功能准确确定有氧运动能力的好处，特别是在确定运动训练计划的好处方面。此外，这些使用心肺运动测试和有效的生活质量评估的数据表明，心脏康复计划在改善患有冠心病的年轻人和老年人的有氧运动能力和生活质量方面具有不同的效果。
PURPOSE: Although cardiopulmonary exercise variables predict prognosis, functional capacity, and quality of life (QoL) in patients with coronary artery disease (CAD), these variables have not been assessed fully before and after exercise training in elderly with CAD. Therefore, the purpose of this study was to determine the impact of formal Phase II cardiac rehabilitation and exercise training programs on cardiopulmonary variables and QoL in elderly and younger CAD patients.METHODS: The authors analyzed consecutive patients before and after Phase II cardiac rehabilitation and exercise training programs, and compared exercise cardiopulmonary data and data from validated questionnaires assessing QoL (MOS SF-36) and function in 125 younger patients (< 55 years; mean 48 +/- 6 years) and 57 elderly (> 70 years; mean 78 +/- 3 years).RESULTS: At baseline, elderly patients had lower estimated aerobic exercise capacity (-27%; P < 0.001), peak oxygen consumption (VO2) (-19%; P < 0.01), and anaerobic threshold (-10%; P < 0.05), as well as total function scores (-11%; P < 0.01) and total QoL scores (-5%; P = 0.06). Commonly used prediction equations greatly overestimated aerobic exercise capacity compared with precise measurements using cardiopulmonary testing both before (+23% and +12% in younger and elderly patients, respectively) and after the exercise training programs (+51% and +31% in younger and elderly patients, respectively), and more so in younger compared with older patients. After rehabilitation, the elderly had significant improvements in estimated aerobic exercise capacity (+32%; P < 0.0001), peak VO2 (+13%; P < 0.0001), anaerobic threshold (+11%; P = 0.03), total function scores (+27%; P < 0.0001), and total QoL scores (+20%; P < 0.0001). Although younger patients had greater improvements in estimated aerobic exercise capacity (+44% versus +32%; P = 0.08), peak VO2 (+18% versus +13%; P < 0.01), and anaerobic threshold (+17% versus +11%; P = 0.07), the elderly had statistically greater improvements in both function scores (+27% versus +20%; P = 0.02), and total QoL scores (+20% versus +14%; P = 0.03).CONCLUSIONS: These data confirm the benefits of precisely determining aerobic exercise capacity by cardiopulmonary function, especially to determine the benefits of an exercise training program. In addition, these data using cardiopulmonary exercise tests and validated assessments of quality of life demonstrate the disparate effects of cardiac rehabilitation programs on improvements in aerobic exercise capacity and QoL in young and elderly with CAD.