Exercise Capacity, Coronary Artery Fatty Plaque, Coronary Calcium Score, and Cardiovascular Events in Subjects With Stable Coronary Artery Disease.
Exercise Capacity, Coronary Artery Fatty Plaque, Coronary Calcium Score, and Cardiovascular Events in Subjects With Stable Coronary Artery Disease.
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稳定型冠状动脉疾病受试者的运动能力、冠状动脉脂肪斑块、冠状动脉钙评分和心血管事件。
DOI：
10.1161/jaha.119.014919
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发表时间：
2020
影响因子：
5.4
通讯作者：
Welty,FrancineK
中科院分区：
文献类型：
--
作者：
Malik,Abdulaziz;Kanduri,JayaS;Asbeutah,AbdulAzizA;Khraishah,Haitham;Shen,Changyu;Welty,FrancineK
背景有氧运动能力与非冠心病(CAD)男性和女性心血管疾病和全因死亡率呈负相关；然而，在CAD患者中，高强度运动量与J形关系相关。因此，CAD患者的最佳运动类型和运动量尚不清楚。冠状动脉钙化(CAC)与心血管疾病(CVD)事件和死亡率的增加有关。脂肪斑块比其他类型更容易破裂并导致冠状动脉事件。方法与结果根据运动平板运动试验计算出的代谢当量任务(METS)，将270例稳定型CAD患者分为三组。进行自我报告的锻炼。冠状动脉CT血管成像测量冠状动脉斑块体积和CAC评分。调整后，3组大鼠脂肪斑块体积差异无统计学意义。每增加1个MET，CAC值降低66.2U(P=0.017)。那些患有CAC>；400和≥8.2Met的患者在30个月内发生心血管疾病的事件比那些患有8.2Met的患者更少(P=0.037)。中等强度运动者(中位数为240min/wk；78%仅步行)，62.4%达到≥8.2Met和较低的CAC值(P=0.07)。运动强度和持续时间对冠状动脉斑块或心血管事件无不良影响。结论达到中等运动强度和运动量的≥8.2Met，CAC评分较低，心血管事件较少。因此，冠心病患者可能不需要剧烈运动强度和运动量就能受益。注册URL：https://www.clinicaltrials.gov；唯一标识：NCT01624727。
BackgroundAerobic exercise capacity is inversely associated with cardiovascular and all‐cause mortality in men and women without coronary artery disease (CAD); however, a higher amount of vigorous exercise is associated with a J‐shaped relationship in CAD patients. Therefore, the optimal type and amount of exercise for CAD patients is unclear. Coronary artery calcification (CAC) is associated with increased cardiovascular disease (CVD) events and mortality. Fatty plaque is more likely to rupture and cause coronary events than other types. We examined the association between exercise capacity, fatty plaque, CAC score and CVD events in CAD patients.Methods and ResultsA total of 270 subjects with stable CAD were divided into tertiles based on metabolic equivalents of task (METs) calculated from exercise treadmill testing. Self‐reported exercise was obtained. Coronary computed tomographic angiography measured coronary plaque volume and CAC score. After adjustment, fatty plaque volume was not different among the 3 MET groups. For each 1 MET increase, CAC was 66.2 units lower (P=0.017). Those with CAC >400 and ≥8.2 METs had fewer CVD events over 30 months compared to <8.2 METs (P=0.037). Of moderate intensity exercisers (median, 240 min/wk; 78% walking only), 62.4% achieved ≥8.2 METs and lower CAC scores (P=0.07). Intensity and duration of exercise had no adverse impact on coronary plaque or CVD events.ConclusionsAchieving ≥8.2 METs with moderate exercise intensity and volume as walking resulted in lower CAC scores and fewer CVD events. Therefore, vigorous exercise intensity and volume may not be needed for CAD patients to derive benefit.RegistrationURL: https://www.clinicaltrials.gov; Unique Identifier: NCT01624727.
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DOI：
10.1016/s0021-9258(19)68075-0
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1982
期刊：
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DOI：
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1985
期刊：
Journal of immunology (Baltimore, Md. : 1950)
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