PDF(Pubmed)
Abstract：
Cardiac telerehabilitation offers a flexible and accessible model for patients with coronary artery disease (CAD), effectively transforming the traditional cardiac rehabilitation (CR) approach.
This systematic review and meta-analysis aimed to evaluate the long-term effectiveness of cardiac telerehabilitation.
We searched randomized controlled trials (RCTs) in 7 electronic databases: PubMed, Web of Science, EMBASE, the Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, the China National Knowledge Infrastructure, and WANFANG. The primary outcome focused on cardiopulmonary fitness. For secondary outcomes, we examined cardiovascular risk factors (blood pressure, BMI, and serum lipids), psychological scales of depression and anxiety, quality of life (QoL), cardiac telerehabilitation adherence, and adverse events.
In total, 10 RCTs fulfilled the predefined criteria, which were reviewed in our meta-analysis. The results showed that after cardiac telerehabilitation, there was a significant difference in the improvement in long-term peak oxygen uptake compared to center-based CR (mean difference [MD] 1.61, 95% CI 0.38-2.85, P=.01), particularly after 6-month rehabilitation training (MD 1.87, 95% CI 0.34-3.39, P=.02). The pooled effect size of the meta-analysis indicated that there were no significant differences in the reduction in cardiovascular risk factor control. There was also no practical demonstration of anxiety scores or depression scores. However, cardiac telerehabilitation demonstrated an improvement in the long-term QoL of patients (MD 0.92, 95% CI 0.06-1.78, P=.04). In addition, the study reported a high completion rate (80%) for cardiac telerehabilitation interventions. The incidence of adverse events was also low during long-term follow-up.
Cardiac telerehabilitation proves to be more effective in improving cardiopulmonary fitness and QoL during the long-term follow-up for patients with CAD. Our study highlights monitoring-enabled and patient-centered telerehabilitation programs, which play a vital role in the recovery and development of CAD and in the long-term prognosis of patients.
This systematic review and meta-analysis aimed to evaluate the long-term effectiveness of cardiac telerehabilitation.
We searched randomized controlled trials (RCTs) in 7 electronic databases: PubMed, Web of Science, EMBASE, the Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, the China National Knowledge Infrastructure, and WANFANG. The primary outcome focused on cardiopulmonary fitness. For secondary outcomes, we examined cardiovascular risk factors (blood pressure, BMI, and serum lipids), psychological scales of depression and anxiety, quality of life (QoL), cardiac telerehabilitation adherence, and adverse events.
In total, 10 RCTs fulfilled the predefined criteria, which were reviewed in our meta-analysis. The results showed that after cardiac telerehabilitation, there was a significant difference in the improvement in long-term peak oxygen uptake compared to center-based CR (mean difference [MD] 1.61, 95% CI 0.38-2.85, P=.01), particularly after 6-month rehabilitation training (MD 1.87, 95% CI 0.34-3.39, P=.02). The pooled effect size of the meta-analysis indicated that there were no significant differences in the reduction in cardiovascular risk factor control. There was also no practical demonstration of anxiety scores or depression scores. However, cardiac telerehabilitation demonstrated an improvement in the long-term QoL of patients (MD 0.92, 95% CI 0.06-1.78, P=.04). In addition, the study reported a high completion rate (80%) for cardiac telerehabilitation interventions. The incidence of adverse events was also low during long-term follow-up.
Cardiac telerehabilitation proves to be more effective in improving cardiopulmonary fitness and QoL during the long-term follow-up for patients with CAD. Our study highlights monitoring-enabled and patient-centered telerehabilitation programs, which play a vital role in the recovery and development of CAD and in the long-term prognosis of patients.
摘要：
心脏远程康复为冠状动脉疾病（CAD）患者提供了灵活且易于使用的模型，有效地改变传统的心脏康复（CR）方法。
本系统综述和荟萃分析旨在评估心脏远程康复的长期有效性。
我们在7个电子数据库中搜索了随机对照试验（RCT）：PubMed，WebofScience,EMBASE,Cochrane中央受控试验登记册,ClinicalTrials.gov,中国国家知识基础设施，和万方。主要结果集中在心肺适应性。对于次要结果，我们检查了心血管危险因素(血压、BMI,和血清脂质)，抑郁和焦虑的心理量表，生活质量（QoL），心脏康复依从性，和不良事件。
总共，10个RCT满足预定义的标准，在我们的荟萃分析中进行了综述。结果表明，在心脏康复治疗后，与基于中心的CR相比，长期峰值摄氧量的改善存在显着差异（平均差异[MD]1.61，95％CI0.38-2.85，P=0.01），特别是经过6个月的康复训练（MD1.87，95%CI0.34-3.39，P=.02）。荟萃分析的汇总效应大小表明，心血管危险因素控制的减少没有显着差异。也没有焦虑分数或抑郁分数的实际证明。然而,心脏康复治疗显示患者的长期QoL有所改善(MD0.92,95%CI0.06-1.78,P=.04).此外,该研究报告了心脏远程康复干预的高完成率(80%).在长期随访期间，不良事件的发生率也很低。
在冠心病患者的长期随访中，心脏远程康复被证明在改善心肺适应性和QoL方面更有效。我们的研究强调了以监测为基础和以患者为中心的远程康复计划，在CAD的恢复和发展以及患者的长期预后中起着至关重要的作用。
本系统综述和荟萃分析旨在评估心脏远程康复的长期有效性。
我们在7个电子数据库中搜索了随机对照试验（RCT）：PubMed，WebofScience,EMBASE,Cochrane中央受控试验登记册,ClinicalTrials.gov,中国国家知识基础设施，和万方。主要结果集中在心肺适应性。对于次要结果，我们检查了心血管危险因素(血压、BMI,和血清脂质)，抑郁和焦虑的心理量表，生活质量（QoL），心脏康复依从性，和不良事件。
总共，10个RCT满足预定义的标准，在我们的荟萃分析中进行了综述。结果表明，在心脏康复治疗后，与基于中心的CR相比，长期峰值摄氧量的改善存在显着差异（平均差异[MD]1.61，95％CI0.38-2.85，P=0.01），特别是经过6个月的康复训练（MD1.87，95%CI0.34-3.39，P=.02）。荟萃分析的汇总效应大小表明，心血管危险因素控制的减少没有显着差异。也没有焦虑分数或抑郁分数的实际证明。然而,心脏康复治疗显示患者的长期QoL有所改善(MD0.92,95%CI0.06-1.78,P=.04).此外,该研究报告了心脏远程康复干预的高完成率(80%).在长期随访期间，不良事件的发生率也很低。
在冠心病患者的长期随访中，心脏远程康复被证明在改善心肺适应性和QoL方面更有效。我们的研究强调了以监测为基础和以患者为中心的远程康复计划，在CAD的恢复和发展以及患者的长期预后中起着至关重要的作用。
