Cardiac Rehabilitation Participation Rates and Outcomes for Patients With Heart Failure
Cardiac Rehabilitation Participation Rates and Outcomes for Patients With Heart Failure
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心力衰竭患者的心脏康复参与率和结果
DOI：
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发表时间：
2017
影响因子：
3.8
通讯作者：
P. Ades
中科院分区：
文献类型：
--
作者：
Jason L. Rengo;P. Savage;T. Barrett;P. Ades
目的：运动训练已被证明可以降低射血分数降低（HFrEF）慢性心力衰竭（CHF）患者的心血管死亡率和住院率。虽然在研究环境中有大量关于HFrEF患者运动训练的数据，但在临床环境中提供心脏康复（CR）服务的经验尚未得到很好的描述。由于对美国合格的HFrEF患者数量知之甚少，我们描述了招募住院患者和稳定门诊患者进入II期CR的18个月经验。方法：对因CHF HFrEF住院的患者进行跟踪，以招募CR。描述了确定为住院患者的患者和从心脏病诊所或心力衰竭诊所转诊的稳定HFrEF门诊患者的运动训练反应。结果：该队列包括83例CHF住院患者和36例门诊患者。CHF住院后，只有17%（14/83）的合格HFrEF住院患者入组CR，而门诊转诊患者为97%（35/36）。对于完成CR的患者，无论是以估计的代谢当量（n = 19，4.6 ± 1.6至6.2 ± 2.4，P <0.0001）或O2峰值（n = 14，14.4 ± 3.5至16.4 ± 4.6 mL/kg/min，P = 0.02）表示，均观察到总队列的有氧能力改善。结论：观察到招募和入组HFrEF患者的显著障碍，只有17%的住院患者接受CR。系统性院内转诊和门诊密切随访有可能捕获更多合格患者。转诊的HFrEF稳定门诊患者的参与率要高得多。无论转诊来源如何，完成CR的HFrEF患者均可预期有氧能力、肌肉力量和抑郁症状的改善。
Purpose: Exercise training has been shown to reduce combined cardiovascular mortality and hospitalizations in patients with chronic heart failure (CHF) with reduced ejection fraction (HFrEF). Whereas there are extensive data on exercise training for individuals with HFrEF in a research setting, the experience of delivering cardiac rehabilitation (CR) services in the clinical setting has not been well described. With little knowledge regarding the number of qualifying patients with HFrEF in the United States, we described our 18-month experience recruiting hospitalized inpatients and stable outpatients into phase 2 CR. Methods: Patients hospitalized with CHF HFrEF were tracked for enrollment in CR. Exercise training response was described for patients identified as inpatients and for stable HFrEF outpatients referred from cardiology clinic or heart failure clinic. Results: The cohort included 83 patients hospitalized with CHF and 36 outpatients. Only 17% (14/83) of eligible HFrEF inpatients enrolled in CR following CHF hospitalization compared with 97% (35/36) outpatient referrals. Improvements in aerobic capacity for the total cohort were observed whether expressed as estimated metabolic equivalents (n = 19, 4.6 ± 1.6 to 6.2 ± 2.4, P < .0001) or O2peak (n = 14, 14.4 ± 3.5 to 16.4 ± 4.6 mL/kg/min, P = .02) for those who completed CR. Conclusion: Significant barriers to recruiting and enrolling patients with HFrEF were observed and only 17% of inpatients attended CR. Systematic in-hospital referral with close followup in the outpatient setting has the potential to capture more eligible patients. The participation of referred stable outpatients with HFrEF was much higher. Regardless of the referral source, patients with HFrEF completing CR can expect improvements in aerobic capacity, muscle strength, and depressive symptoms.
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影响因子：
120.7
作者：
Flynn, Kathryn E.;Pina, Ileana L.;Whellan, David J.;Lin, Li;Blumenthal, James A.;Ellis, Stephen J.;Fine, Lawrence J.;Howlett, Jonathan G.;Keteyian, Steven J.;Kitzman, Dalane W.;Kraus, William E.;Miller, Nancy Houston;Schulman, Kevin A.;Spertus, John A.;O'Connor, Christopher M.;Weinfurt, Kevin P.
通讯作者：
Weinfurt, Kevin P.
DOI：
10.1016/j.jchf.2013.09.002
发表时间：
2013-12
期刊：
JACC. Heart failure
影响因子：
--
作者：
Ades PA;Keteyian SJ;Balady GJ;Houston-Miller N;Kitzman DW;Mancini DM;Rich MW
通讯作者：
Rich MW
影响因子：
120.7
作者：
O'Connor, Christopher M.;Whellan, David J.;Lee, Kerry L.;Keteyian, Steven J.;Cooper, Lawton S.;Ellis, Stephen J.;Leifer, Eric S.;Kraus, William E.;Kitzman, Dalane W.;Blumenthal, James A.;Rendall, David S.;Miller, Nancy Houston;Fleg, Jerome L.;Schulman, Kevin A.;McKelvie, Robert S.;Zannad, Faiez;Pina, Ileana L.
通讯作者：
Pina, Ileana L.
影响因子：
158.5
作者：
RICH, MW;BECKHAM, V;CARNEY, RM
通讯作者：
CARNEY, RM