【論文摘要】The Effects of Cardiac Rehabilitation on Ventilatory Efficiency in Patients With Acute Coronary Syndrome

【論文摘要】心臟復健針對急性冠狀動脈徵候群病患換氣效率之影響

林睿安(Ruei-An Lin) ； 許閔傑(Min-Chieh Hsu) ； 蔣尚霖(Shang-Lin Chiang) ； 黎桂珍(Kuei-Chen Lee)

《物理治療》 45卷2期 (2020/06) Pp. 143-144

https://doi.org/10.6215/FJPT.202006.P12

摘要

Background and Purpose: The minute ventilation/ carbon dioxide production slope (VE/VCO_2 slope) and lowest VE/VCO_2 ratio are indicators of predicting mortality in patients with coronary artery disease (CAD), and the risk of mortality is believed to increase when the VE/VCO_2 slope and the lowest ratio get higher. Though, there are few studies discussing the relationship between VE/VCO_2 ratio at anaerobic threshold (VE/VCO_2 @ AT) and prognosis. Also, there were limited data discussing the training effect on reducing the VE/VCO_2 ratio at anaerobic threshold (VE/VCO_2 @ AT) in patients with acute coronary syndrome (ACS). The aim of this study was to evaluate the effect of cardiac rehabilitation (CR) program on reducing VE/VCO_2 @ AT and the improvement of anaerobic threshold (AT). Methods: Patients with ACS status post PCI were enrolled in the study. They were randomized into two groups, including 49 patients (mean age 56.2 ± 8.9 years) in the training group and 41 (mean age 56.7 ± 13.1 years) in the control group. Patients in the training group underwent the CR programs 30 minutes for 36 sessions with a physiotherapist's supervision and patients in the control group only did home-based exercises with self-monitoring. Before and after the exercises training, both groups performed the symptom-limited exercise test with cycling, and their VE/VCO_2 @ AT, AT, heart rate (HR), VO_2 max and blood pressure (BP) were measured. Results: There was no significant difference of VE/VCO_2 @ AT (control group = 36.59, training group = 36.96; p = 0.788) and AT (control group = 0.841, training group = 0.775; p = 0.146) between the two groups at baseline. After the CR program, the VE/VCO_2 @ AT significantly decreased (-2.98, p = 0.001) in the training group, but no significant reduction in the control group (-0, p = 1.0) compared with their baselines. As a result, there was significant difference of VE/VCO_2 @ AT between two groups (control group = 36.59, training group = 33.98; p = 0.032) after the CR training. Moreover, the AT also significantly improved (3.59 ml/kg/min, p ＜ 0.001) in training group, but no significant difference in the control group (-0.04 ml/kg/min, p = 0.942) compared with their baseline. There was significant difference between two groups (training group = 14.40 ml/kg/ min, control group = 11.94 ml/kg/min; p = 0.005) after the CR training. Conclusion: CR programs for 36 sessions were not only beneficial to reduce VE/VCO_2 @ AT but also improve AT and their exercise performance in patients with ACS. Clinical Relevance: Our results provided evidences to support the effectiveness of appropriate CR programs in reducing VE/VCO_2 @ AT and improve AT in patients with ACS.