ABSTRACT
Objective To study the effects of binary cardiac rehabilitation (CR) composed of hospital-based and home-based CR in patients after acute myocardial infarction (AMI) evaluated by six-minute walking distance (6MWD). Methods A total of 38 post-MI patients were divided into two groups, namely conventional CR group (n=20) and binary CR group (n=18). In the first seven days, CR training was carried out in all 38 patients in our hospital, and then 20 patients were kept at CR training in the hospital (hospital-based CR group), whereas the remaining 18 patients (binary CR group) got tele-monitored walking training at home for eight weeks (binary model). Before discharge from hospital based CR or after 8 weeks CR at home, all patients received Cardiopulmonary Exercise Testing and Six-minute Walk Test, and the data of patients' body mass index (BMI),thyroid function, serum lipid metabolism and echocardiography were collected before and after CR. Results After CR, BMI and low density lipoprotein (LDL) decrease in both groups compared with those before CR[hospital-based group: BMI, (25.99±3.36)kg/m2 vs. (23.04±3.72) kg/m2,P＜0.05; LDL, (3.40±1.38) mg/dl vs. (2.04±0.73)mg/ dl,P＜0.01; binary group: BMI, (24.84±2.70) kg/m2 vs. (22.88±2.56) kg/m2,P＜0.05; LDL, (3.40±1.01) mg/dl vs. (92.11±0.37) mg/dl,P＜0.01]. After 8 weeks CR at home or hospital based CR until discharge, the anaerobic threshold (AT), maximum rate of oxygen consumption (VO2max),metabolic equivalent (MET) and 6MWD improved significantly in both groups compared with those at 7 days after CR in hospital [Hospital-based group: AT, (12.37±1.53) mL/(kg. min) vs. (14.77±1.57) mL/(kg. min); VO2max (17.87± 1.66 mL/(kg. min) vs. (20.73±2.14) mL/(kg. min); MET (5.02±0.36) vs. (6.09±0.53); 6MWD (500±53.36) m vs. (582.5±57.6) m,P＜0.01; Binary group: AT, (12.56±1.11) mL/(kg·min) vs. (14.30±1.23) mL/(kg. min); V02max, (17.28±1.38) mL/(kg. min) vs. (20.02±1.37) mL/(kg. min); MET, (5.07±0.47)vs (5.94±0.46); 6MWD,(511.4±50.96) m vs. (590.3±56.1)m,P＜0.01]. There was no significant difference in CR effects observed between two groups (P＞0.05). Conclusions In post-MI patients,a binary model of CR training improved physical capacity and was a similarly effective form of CR as a entirely hospital-based approach. A home-based tele-monitored program facilitated patients' adherence to CR. The 6 minute walk experiment is economical and good evaluation on the CR effect of binary cardiac rehabilitation.
ABSTRACT
Objective To investigate the diagnostic value of blood homocysteine,ankle -brachial index and brachial -ankle pulse wave velocity in elderly patients with coronary heart disease (CHD).Methods 97 patients with routine coronary angiography were classified into CHD group (65 cases)and non -CHD group (32 cases) according to the results of coronary angiography.There were 24 cases with single -vessel disease in 65 CHD cases, 21 cases with double -vessel disease and 20 patients with multivessel disease of CHD.Basic clinical parameters,age, gender,TC,TG,LDL -C,HDL -C,etc and blood HCY,ABI,baPWV levels were compared among groups.Results The age of double -vessel disease group,multivessel disease group was significantly higher than that in single -vessel disease group(t =3.721,3.927,all P 0.05),and the ABI of multi -vessel disease,double vessel disease group were significantly lower than that of non -CHD group (all P <0.01).HCY,baPWV of CHD group were significantly higher than non -CHD group(all P <0.01 ),double vessel disease,HCY multivessel disease group,ABI,baPWV average water with single -vessel disease group were signifi-cantly different(all P <0.01 ).With the increase of coronary lesions involved,the blood HCY,baPWV showed an increasing trend and ABI showed an decreasing trend.Conclusion Combined detection of HCY,baPWV and ABI has great value in early detection and early intervention of CHD in the elderly.