Effects of cardiac exercise rehabilitation on heart failure with preserved ejection fraction / 中国基层医药

ABSTRACT

Objective:To investigate the effects of cardiac exercise rehabilitation on heart failure with preserved ejection fraction.Methods:200 patients with clinically diagnosed heart failure with preserved ejection fraction who received treatment from May to December 2019 were included in this study. They were randomly assigned to receive either routine treatment (control group, n = 100) or routine treatment combined with cardiac exercise rehabilitation (observation group, n = 100). Before and after treatment, the distance walked during the 6-minute walk test was compared between the control and observation groups. Before and after treatment, plasma level of brain natriuretic peptide, left ventricular ejection fraction, left ventricular short-axis fractional shortening, left atrial diameter, left ventricular end diastolic diameter were compared between the two groups. Adverse events such as falls during treatment were recorded in each group. Before and after treatment, quality of life was evaluated using The Minnesota Living With Heart Failure Questionnaire in each group. All patients were followed up for 3 months. Three-month rehospitalization rate was calculated in each group. Results:After treatment, the distance walked during the 6-minute walk test in the observation group was significantly longer than that in the control group [(421.63 ± 86.75) m vs. (328.44 ± 74.93) m, t = 8.130, P < 0.001). After treatment, the distance walked during the 6-minute walk test in each group was significantly increased compared with before treatment ( tcontrol group = 6.584, P < 0.001; tobservation group = 15.337, P < 0.001). After treatment, plasma level of brain natriuretic peptide in the observation group was significantly lower than that in the control group [(227.68 ± 31.22) mg/L vs. (269.74 ± 36.81) mg/L, t = 8.714, P < 0.001]. After treatment, plasma level of brain natriuretic peptide in each group was significantly decreased compared with before treatment ( tcontrol group = 24.669, P < 0.001; tobservation group = 38.776, P < 0.001). After treatment, left ventricular end diastolic diameter and left atrial diameter in each group were significantly decreased compared with before treatment ( t = 4.031, 10.166, 3.715 and 12.569, all P < 0.05), while left ventricular ejection fraction and left ventricular short-axis fractional shortening in each group were significantly increased compared with before treatment ( t = 7.610, 11.906, 3.915 and 6.105, all P < 0.05). The amplitude of improvement in abovementioned indices in the observation group was significantly greater than that in the control group ( t = 7.255, 12.739, 4.703 and 2.442, all P < 0.05). During the treatment, no falls, adverse cardiovascular events, or death occurred in each group. After treatment, the Minnesota Living With Heart Failure Questionnaire scores in physical domain, emotional domain and other domains in the observation group were (23.96 ± 4.75) points, (9.47 ± 2.02) points, (26.31 ± 1.84) points, respectively, which were significantly lower than those in the control group [(28.63 ± 5.12) points, (12.35 ± 1.89) points and (32.76 ± 2.49) points, t = 6.867, 10.411 and 20.833, all P < 0.001]. After treatment, the Minnesota Living With Heart Failure Questionnaire scores in various domains in each group were significantly decreased compared with before treatment ( t = 6.648, 14.746, 28.782, 35.262, 9.665 and 27.962, all P < 0.05). Three-month rehospitalization rate in the observation group was significantly lower than that in the control group [10.0% (10/100) vs. 22.0% (22/100), χ2 = 5.357, P = 0.021]. Conclusion:Cardiac exercise rehabilitation for the treatment of heart failure with preserved ejection fraction can help improve the heart function, increase exercise endurance, improve prognosis, reduce rehospitalization rate, and improve quality of life.