基于家庭的远程心脏康复对经皮冠状动脉介入治疗（PCI）后患者左心室功能和运动恐惧的影响：一项回顾性队列研究。

Effects of Home-based Remote Cardiac Rehabilitation on Left Ventricular Function and Fear of Exercise in Patients after Percutaneous Coronary Intervention (PCI): A Retrospective Cohort Study.

机构信息

General Practice, Longhua Sub-district Community Health Service Center in Xuhui District, 200232 Shanghai, China.

Longhua New Village Team, Longhua Sub-district Community Health Service Center in Xuhui District, 200232 Shanghai, China.

出版信息

Heart Surg Forum. 2023 Dec 27;26(6):E855-E862. doi: 10.59958/hsf.6827.

DOI:10.59958/hsf.6827

PMID:38178347

Abstract

AIM

This study aims to explore the effects of home-based remote cardiac rehabilitation on left ventricular function and exercise fear in patients after percutaneous coronary intervention (PCI).

METHODS

A total of 232 patients with coronary heart disease after PCI treated in Tianshan Traditional Chinese Medicine Hospital from January 2020 to December 2022 were retrospectively analyzed. The patients were divided into the remote rehabilitation group (169 cases) and the routine group (63 cases) according to the exposure factor (home-based remote cardiac rehabilitation). Changes in left ventricular function and sports phobia Tampa Scale in patients with coronary heart disease after PCI were compared using propensity score matching to reduce selection bias and confounding factors.

RESULTS

After the intervention, the scores of patients in the tele-rehabilitation group were significantly higher than those in the conventional group in terms of fear of movement, perception of danger, fear of movement, avoidance of movement, and dysfunction (p-value < 0.05). Left heart function was compared between the tele-rehabilitation group and the conventional group. Patients in the tele-rehabilitation group had significantly higher peak mitral valve blood flow in the early diastolic period (E), peak mitral valve blood flow in the late diastolic period (A), six-minute walk test (6MWT), and ratio of the peak mitral valve blood flow in the early diastolic period to the peak mitral valve blood flow in the late diastolic period (E/A) than those in the conventional group (p-value < 0.05). However, the peak deceleration time and isovolumic diastolic time in the early mitral valve diastolic period were significantly higher in the tele-rehabilitation group than in the conventional group (p-value < 0.05).

CONCLUSIONS

Home-based remote cardiac rehabilitation instruction can improve the heart function and exercise fear state of patients after PCI.

摘要

目的

本研究旨在探讨基于家庭的远程心脏康复对经皮冠状动脉介入治疗（PCI）后患者左心室功能和运动恐惧的影响。

方法

回顾性分析 2020 年 1 月至 2022 年 12 月在天山中医院接受 PCI 治疗的 232 例冠心病患者。根据暴露因素（基于家庭的远程心脏康复）将患者分为远程康复组（169 例）和常规组（63 例）。采用倾向评分匹配法减少选择偏倚和混杂因素，比较 PCI 后冠心病患者左心室功能和运动恐惧坦帕量表的变化。

结果

干预后，远程康复组患者在运动恐惧、危险感知、运动恐惧、运动回避和功能障碍方面的评分明显高于常规组（p 值<0.05）。比较远程康复组和常规组的左心功能，远程康复组患者的早期舒张期二尖瓣血流峰值（E）、晚期舒张期二尖瓣血流峰值（A）、六分钟步行试验（6MWT）和早期舒张期二尖瓣血流峰值与晚期舒张期二尖瓣血流峰值的比值（E/A）均明显高于常规组（p 值<0.05）。但远程康复组早期二尖瓣舒张期峰值减速时间和等容舒张期时间明显高于常规组（p 值<0.05）。