Objective To investigate the effects of different training intensities on cardiopulmonary function in patients with coronary heart disease after percutaneous coronary intervention (PCI). Methods A total of 100 patients with coronary heart disease who were hopitalized from July 2020 to February 2022 and successfully underwent PCI were selected and divided into a control group (50 cases) and a study group (50 cases) by random number table method. The control group (moderate intensity continuous training) had a maximum oxygen uptake (VO2) of 40% to 59% or a maximum heart rate of 55% to 69% as the training load, while the study group (high intensity interval training) had a maximum VO2 of >80% or a maximum heart rate of 85% to 95% as the training load. The two groups of patients exercised on an ergometer for 30 min per time, 3 times a week, for 4 consecutive weeks, and received conventional drug treatment. All patients underwent cardiac ultrasound and cardiopulmonary exercise test (CPET) before and after rehabilitation to evaluate cardiopulmonary function and exercise endurance. Results There were no significant differences in age, sex, and history of diseases between the two groups. Before rehabilitation, there were no significant differences in left ventricular ejection fractions (LVEF), oxygen uptake at anaerobic threshold (VO2 AT), peak oxygen uptake (peak VO2), oxygen pulse, and ventilatory equivalent for carbon dioxide (VE/VCO2) slope between the study group and the control group. The changes before and after rehabilitation in VO2 AT, peak VO2, oxygen pulse, and minute ventilation volume (VE) were significantly higher in the study group than in the control group (P<0.05). Spearman correlation analysis showed that the change values of VO2 AT, peak VO2, oxygen pulse, and VE were positively correlated with training intensity (P<0.05). Conclusions Compared with moderate intensity continuous aerobic exercise, high intensity interval aerobic exercise can better improve the aerobic metabolic capacity and exercise endurance of patients with coronary heart disease after PCI.
[1] 袁丽霞,丁荣晶. 中国心脏康复与二级预防指南解读[J]. 中国循环杂志,2019, 34(1): 86-90.
[2] Deniz Acar R, Bulut M, Ergün S, et al.Effect of cardiac rehabilitation on left atrial functions in patients with acute myocardial infarction[J]. Ann Phys Rehabil Med, 2014, 57(2): 105-113.
[3] 唐海沁,符赵鑫,张亚文,等. 冠心病血运重建患者运动康复疗效及安全性荟萃分析[J]. 中华心血管病杂志,2014,42(4): 334-339.
[4] Lee JY, Ahn JM, Park DW, et al.Impact of exercise-based cardiac rehabilitation on long-term clinical outcomes in patients with left main coronary artery stenosis[J]. Eur J Prev Cardiol,2016, 23(17): 1804-1813.
[5] Tsai YJ, Li MH, Chen CH, et al.Improved oxygen uptake efficiency slope in acute myocardial infarction patients after early phase Ⅰ cardiac rehabilitation[J]. Int J Rehabil Res, 2017, 40(3): 215-219.
[6] Zhang H, Chang R.Effects of exercise after percutaneous coronary intervention on cardiac function and cardiovascular adverse events in patients with coronary heart disease: systematic review and meta-analysis[J]. J Sports Sci Med, 2019, 18(2): 213-222.
[7] Darmian MA, Hoseini R, Amiri E, et al.Downregulated hs-CRP and MAD, upregulated GSH and TAC, and improved metabolic status following combined exercise and turmeric supplementation: a clinical trial in middle-aged women with hyperlipidemic type 2 diabetes[J]. J Diabetes Metab Disord, 2022, 21(1): 275-283.
[8] D'Amuri A, Raparelli V, Sanz JM, et al. Biological response of irisin induced by different types of exercise in obese subjects: a non-inferiority controlled randomized study[J]. Biology (Basel),2022, 11(3): 392.
[9] Smart NA, Dieberg G, Giallauria F.Intermittent versus continuous exercise training in chronic heart failure: a meta-analysis[J]. Int J Cardiol, 2013, 166(2): 352-358.
[10] Arena R, Myers J, Forman DE, et al.Should high-intensity-aerobic interval training become the clinical standard in heart failure[J]. Heart Fail Rev, 2013, 18(1): 95-105.
[11] Lalande S, Luoma CE, Miller AD, et al.Expiratory loading improves cardiac output during exercise in heart failure[J]. Med Sci Sports Exerc, 2012, 44(12): 2309-2314.
[12] Zhong XJ, Jiang R, Yang L, et al.Peak oxygen uptake is a strong prognostic predictor for pulmonary hypertension due to left heart disease[J]. BMC Cardiovasc Disord, 2022, 22(1): 137.
[13] Główczyńska R, Piotrowicz E, Szalewska D, et al.Effects of hybrid comprehensive telerehabilitation on cardiopulmonary capacity in heart failure patients depending on diabetes mellitus: subanalysis of the TELEREH-HF randomized clinical trial[J]. Cardiovasc Diabetol, 2021, 20(1): 106.
[14] Agostoni P, Sciomer S, Palermo P, et al.Minute ventilation/carbon dioxide production in chronic heart failure[J]. Eur Respir Rev, 2021, 30(159): 200141.
[15] McConnell TR, Mandak JS, Sykes JS, et al. Exercise training for heart failure patients improves respiratory muscle endurance, exercise tolerance, breathlessness, and quality of life[J]. J Cardiopulm Rehabil, 2003, 23(1): 10-16.
[16] Gademan MG, Swenne CA, Verwey HF, et al.Exercise training increases oxygen uptake efficiency slope in chronic heart failure[J]. Eur J Cardiovasc Prev Rehabil, 2008, 15(2): 140-144.
[17] Stein R, Chiappa GR, Güths H, et al.Inspiratory muscle training improves oxygen uptake efficiency slope in patients with chronic heart failure[J]. J Cardiopulm Rehabil Prev, 2009, 29(6): 392-395.
[18] Tsuyuki K, Kimura Y, Chiashi K, et al.Oxygen uptake efficiency slope as monitoring tool for physical training in chronic hemodialysis patients[J]. Ther Apher Dial, 2003, 7(4): 461-467.
[19] Van Laethem C, Van De Veire N, De Backer G, et al. Response of the oxygen uptake efficiency slope to exercise training in patients with chronic heart failure[J]. Eur J Heart Fail, 2007, 9(6-7): 625-629.
[20] Myers J, Dziekan G, Goebbels U, et al.Influence of high-intensity exercise training on the ventilatory response to exercise in patients with reduced ventricular function[J]. Med Sci Sports Exerc, 1999, 31(7): 929-937.
[21] Defoor J, Schepers D, Reybrouck T, et al.Oxygen uptake efficiency slope in coronary artery disease: clinical use and response to training[J]. Int J Sports Med, 2006, 27(9): 730-737.
[22] Guazzi M, Borlaug B, Metra M, et al.Revisiting and implementing the Weber and ventilatory functional classifications in heart failure by cardiopulmonary imaging phenotyping[J]. J Am Heart Assoc, 2021, 10(5): e018822.
[23] Guiraud T, Nigam A, Juneau M, et al.Acute responses to high-intensity intermittent exercise in CHD patients[J]. Med Sci Sports Exerc, 2011, 43(2): 211-217.
[24] Cerini T, Hilfiker R, Riegler TF, et al.12 weeks high intensity interval training versus moderate intensity continuous training in chronic low back pain subjects: a randomised single-blinded feasibility study[J]. Arch Physiother, 2022, 12(1): 12.
[25] Songstad NT, Kaspersen KH, Hafstad AD, et al.Effects of high intensity interval training on pregnant rats, and the placenta, heart and liver of their fetuses[J]. PLoS One, 2015, 10(11): e0143095.
[26] 胡强,张剑,张权宇. 高强度间歇运动在冠心病患者中的应用[J]. 心脏杂志,2022, 34(2): 220-227.