PDF(Pubmed)
Abstract：
BACKGROUND: Historically, the majority of patients admitted to inpatient exercise-based cardiac rehabilitation (EBCR) have undergone open heart surgery (OHS). However, with advances in minimally invasive cardiac surgery (MICS), these patient groups are also increasingly referred for inpatient EBCR. Herein, we aimed to compare the progress of these groups during rehabilitation.
METHODS: In this prospective, nonrandomized study, 403 inpatient EBCR patients were recruited from December 2022 until September 2023 and stratified into two groups: OHS, and MICS. Participants completed a 3-4-week certified EBCR program. The primary endpoint was defined as a change in the 6-minute walk test (6MWT). Moreover, a comprehensive panel of quality-of-life (QoL) assessments were performed at admission and discharge.
RESULTS: At baseline, patients with OHS were older (66 years [IQR 59 - 72]), more often male (83%), and underwent emergency/urgent procedures more often (20%) than patients with MICS. Furthermore, patients with MICS showed a better 6MWT at admission (426 meters [IQR 336 - 483]) compared to patients with OHS (381 meters [IQR 299 - 453]). While all patients were able to increase the distance in the 6MWT, regression analyses in fully adjusted models showed no difference in improvements between the two groups (β -5, 95% CI, -26 - 14, p = 0.58). Moreover, during EBCR, we observed significant improvements in all QoL measures in all groups.
CONCLUSIONS: In this study, improvements in fitness, as assessed by the 6WMT were observed in all groups. Furthermore, multiple QoL measures improved equally across all groups. These encouraging results emphasize the importance of EBCR.
METHODS: In this prospective, nonrandomized study, 403 inpatient EBCR patients were recruited from December 2022 until September 2023 and stratified into two groups: OHS, and MICS. Participants completed a 3-4-week certified EBCR program. The primary endpoint was defined as a change in the 6-minute walk test (6MWT). Moreover, a comprehensive panel of quality-of-life (QoL) assessments were performed at admission and discharge.
RESULTS: At baseline, patients with OHS were older (66 years [IQR 59 - 72]), more often male (83%), and underwent emergency/urgent procedures more often (20%) than patients with MICS. Furthermore, patients with MICS showed a better 6MWT at admission (426 meters [IQR 336 - 483]) compared to patients with OHS (381 meters [IQR 299 - 453]). While all patients were able to increase the distance in the 6MWT, regression analyses in fully adjusted models showed no difference in improvements between the two groups (β -5, 95% CI, -26 - 14, p = 0.58). Moreover, during EBCR, we observed significant improvements in all QoL measures in all groups.
CONCLUSIONS: In this study, improvements in fitness, as assessed by the 6WMT were observed in all groups. Furthermore, multiple QoL measures improved equally across all groups. These encouraging results emphasize the importance of EBCR.
摘要：
背景：历史上，大多数接受基于运动的心脏康复(EBCR)的住院患者接受了心脏直视手术(OHS).然而,随着微创心脏手术（MICS）的进步，这些患者群体也越来越多地因住院EBCR而被提及.在这里，我们旨在比较这些群体在康复期间的进展。
方法：在此前瞻性中，非随机研究，从2022年12月至2023年9月招募了403名住院EBCR患者，并将其分为两组：OHS，和MICS。参与者完成了3-4周认证的EBCR计划。主要终点定义为6分钟步行试验（6MWT）的变化。此外，在入院和出院时进行全面的生活质量(QoL)评估.
结果：在基线时，OHS患者年龄较大（66岁[IQR59-72]），更常见的是男性（83%），与MICS患者相比，接受急诊/紧急手术的频率更高（20％）。此外，与OHS患者(381米[IQR299-453])相比,MICS患者在入院时显示出更好的6MWT(426米[IQR336-483]).虽然所有患者都能够增加6MWT的距离，在完全校正模型中进行的回归分析显示,两组间的改善无差异(β-5,95%CI,-26-14,p=0.58).此外，在EBCR期间，我们观察到所有组的所有QoL指标均有显著改善.
结论：在这项研究中，改善健身，通过6WMT评估，在所有组中观察到。此外，多个QoL指标在所有组中的改善程度相同。这些令人鼓舞的结果强调了EBCR的重要性。
方法：在此前瞻性中，非随机研究，从2022年12月至2023年9月招募了403名住院EBCR患者，并将其分为两组：OHS，和MICS。参与者完成了3-4周认证的EBCR计划。主要终点定义为6分钟步行试验（6MWT）的变化。此外，在入院和出院时进行全面的生活质量(QoL)评估.
结果：在基线时，OHS患者年龄较大（66岁[IQR59-72]），更常见的是男性（83%），与MICS患者相比，接受急诊/紧急手术的频率更高（20％）。此外，与OHS患者(381米[IQR299-453])相比,MICS患者在入院时显示出更好的6MWT(426米[IQR336-483]).虽然所有患者都能够增加6MWT的距离，在完全校正模型中进行的回归分析显示,两组间的改善无差异(β-5,95%CI,-26-14,p=0.58).此外，在EBCR期间，我们观察到所有组的所有QoL指标均有显著改善.
结论：在这项研究中，改善健身，通过6WMT评估，在所有组中观察到。此外，多个QoL指标在所有组中的改善程度相同。这些令人鼓舞的结果强调了EBCR的重要性。
