Myneni Pravallika, Bodduluri Monicaa, Gadde Sai T, Nimmagadda Rithish, Manvitha Male, Valiveti Sindhu Chowdary, Sahu Sweta, Younas Salma
General Medicine, Katuri Medical College and Hospital, Guntur, IND.
Internal Medicine, Katuri Medical College and Hospital, Guntur, IND.
Cureus. 2024 Sep 11;16(9):e69224. doi: 10.7759/cureus.69224. eCollection 2024 Sep.
Cardiac rehabilitation (CR) is a structured intervention aimed at improving the clinical outcomes for patients with coronary artery disease (CAD). This systematic review assesses how well different types of CR, such as high-intensity interval training (HIIT), moderate-intensity continuous training (MICT), Nordic walking (NW), and home-based cardiac rehabilitation (HBCR), improve exercise capacity, quality of life, and lower death and illness rates. The objective is to assess the effectiveness of cardiovascular rehabilitation programs in enhancing clinical outcomes for patients diagnosed with CAD. A comprehensive literature search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) model across Google Scholar, EMBASE, PubMed, Medline, and web browsers. Keywords such as "cardiac rehabilitation," "coronary artery disease," "exercise testing," "VO2 peak," and "physical activity" were used in different combinations. Studies were included if they were randomized controlled trials, observational studies, or longitudinal studies published after 2013 in English, with a focus on the impact of CR on CAD. Articles were excluded if they were reviews, meta-analyses, or did not meet the keyword requirements. A total of 375 articles were initially identified with relevant citations. After further screening, 10 studies met the inclusion criteria for analysis. The studies reviewed demonstrated that all forms of CR, including HIIT, MICT, NW, and HBCR, significantly improved exercise capacity and quality of life, and reduced depression severity among CAD patients. Nordic walking showed marked improvements in functional capacity, while HIIT resulted in higher VO2 peak levels compared to moderate-intensity exercise. Home-based CR showed greater adherence rates, especially among older patients and those with strong family support. The results also highlighted the importance of individualized exercise programs to enhance adherence and outcomes. Cardiac rehabilitation is a vital component of secondary prevention in CAD patients, significantly improving clinical outcomes, including exercise capacity, quality of life, and mortality rates. The findings underscore the importance of maintaining and expanding access to CR programs and tailoring interventions to patient needs to optimize long-term health outcomes. Future research should explore the comparative effectiveness of different CR modalities and strategies to increase patient adherence.
心脏康复(CR)是一种结构化干预措施,旨在改善冠状动脉疾病(CAD)患者的临床结局。本系统评价评估了不同类型的心脏康复,如高强度间歇训练(HIIT)、中等强度持续训练(MICT)、越野行走(NW)和居家心脏康复(HBCR),在提高运动能力、生活质量以及降低死亡率和发病率方面的效果如何。目的是评估心血管康复计划对诊断为CAD的患者改善临床结局的有效性。使用系统评价和Meta分析的首选报告项目(PRISMA)模型,在谷歌学术、EMBASE、PubMed、Medline和网络浏览器上进行了全面的文献检索。使用了“心脏康复”“冠状动脉疾病”“运动测试”“最大摄氧量”和“身体活动”等关键词的不同组合。纳入的研究需为2013年后发表的英文随机对照试验、观察性研究或纵向研究,重点是心脏康复对CAD的影响。如果文章是综述、Meta分析或不符合关键词要求,则予以排除。最初共识别出375篇有相关引用的文章。经过进一步筛选,10项研究符合纳入分析的标准。所综述的研究表明,所有形式的心脏康复,包括HIIT、MICT、NW和HBCR,都能显著提高CAD患者的运动能力和生活质量,并降低抑郁严重程度。越野行走在功能能力方面有显著改善,而与中等强度运动相比,HIIT能使最大摄氧量水平更高。居家心脏康复显示出更高的依从率,尤其是在老年患者和有强大家庭支持的患者中。结果还强调了个性化运动计划对提高依从性和改善结局的重要性。心脏康复是CAD患者二级预防的重要组成部分,能显著改善临床结局,包括运动能力、生活质量和死亡率。研究结果强调了维持和扩大心脏康复计划的可及性以及根据患者需求调整干预措施以优化长期健康结局的重要性。未来的研究应探索不同心脏康复方式和策略的比较效果,以提高患者的依从性。