多措并举,推进心脏康复普及和规范发展
徐顺霖,高炜
摘要(Abstract):
<正>近年来,心脏康复在我国得到了很好的推广,重视程度明显提高,但仍存在着认知和实践中的问题。医务人员对心脏康复的认知千差万别,部分学者遵循预防心脏病学的学术理念,着力于生活方式改变和危险因素控制;部分学者认同双心医学的康复意义,着力于心脏病患者的双心健康;也有学者在实践着基于运动的心脏康复,即运动心脏病学的临床范畴。
关键词(KeyWords): 心脏康复;冠心病;普及;规范
基金项目(Foundation):
作者(Author): 徐顺霖,高炜
参考文献(References):
- [1]沈涛,任川,尚志,等.胸痛中心建设背景下心脏康复运动评估的现状[J].中国介入心脏病学杂志,2023,31(7):509-513.DOI:10.3969/j.issn.1004-8812.2023.07.003.
- [2]侯欣宇,李奇峰,李桂华,等.多中心急性心肌梗死患者心脏康复依从性及其相关影响因素分析[J].中国介入心脏病学杂志,2023,31(7):514-520.DOI:10.3969/j.issn.1004-8812.2023.07.004.
- [3]杨珍珍,胥娜,郑文媛,等.体外膜肺氧合患者早期心脏康复的临床获益[J].中国介入心脏病学杂志,2023,31(7):521-525.DOI:10.3969/j.issn.1004-8812.2023.07.005.
- [4]中华医学会心血管病学分会,中国康复医学会心血管病专业委员会,中国老年学会心血管病专业委员会.冠心病康复与二级预防中国专家共识[J].中华心血管病杂志,2013,41(4):267-275.DOI:10.3760/cma.j.issn.0253-3758.2013.04.003.
- [5]中国医师协会心血管内科医师分会预防与康复专业委员会.经皮冠状动脉介入治疗术后运动康复专家共识[J].中国介入心脏病学杂志,2016,24(7):361-369.DOI:10.3969/j.issn.1004-8812.2016.07.001.
- [6]Thomas RJ,Beatty AL,Beckie TM,et al.Home-based cardiac rehabilitation:a scientific statement from the American Association of Cardiovascular and Pulmonary Rehabilitation,the American Heart Association,and the American College of Cardiology[J].JCardiopulm Rehabil Prev,2019,39(4):208-225.DOI:10.1097/HCR.0000000000000447.
- [7]Ambrosetti M,Abreu A,CorràU,et al.Secondary prevention through comprehensive cardiovascular rehabilitation:from knowledge to implementation.2020 update.A position paper from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology[J].Eur J Prev Cardiol,2020,28(5):460-495.DOI:10.1177/2047487320913379.
- [8]McDonagh TA,Metra M,Adamo M,et al.2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure[J].Eur Heart J,2021,42(36):3599-3726.DOI:10.1093/eurheartj/ehab368.
- [9]Heidenreich PA,Bozkurt B,Aguilar D,et al.2022 AHA/ACC/HFSA guideline for the management of heart failure:a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines[J].Circulation,2022,145(18):e895-e1032.DOI:10.1161/CIR.0000000000001063.
- [10]Rea F,Ronco R,Martini N,et al.Cost-effectiveness of posthospital management of acute coronary syndrome:a real-world investigation from Italy[J].Value Health,2022,25(2):185-193.DOI:10.1016/j.jval.2021.07.015.
- [11]Dibben G,Faulkner J,Oldridge N,et al.Exercise-based cardiac rehabilitation for coronary heart disease[J].Cochrane Database Syst Rev,2021,11(11):CD001800.DOI:10.1002/14651858.CD001800.pub4.
- [12]O’Connor CM,Whellan DJ,Lee KL,et al.Efficacy and safety of exercise training in patients with chronic heart failure:HF-ACTION randomized controlled trial[J].JAMA,2009,301(14):1439-1450.DOI:10.1001/jama.2009.454.
- [13]Taylor RS,Walker S,Smart NA,et al.ExTraMATCH IIcollaboration.Impact of exercise-based cardiac rehabilitation in patients with heart failure on mortality and hospitalisation:an individual patient data Meta-analysis of randomized trial[J].Eur JHeart Fail,2018,20(12):1735-1743.DOI:10.1002/ejhf.1311.
- [14]Taylor RS,Walker S,Smart NA,et al.Impact of exercise rehabilitation on exercise capacity and quality-of-life in heart failure:individual participant Meta-analysis[J].J Am Coll Cardiol,2019,73(12):1430-1443.DOI:10.1016/j.jacc.2018.12.072.
- [15]Pandey A,Kitzman D,Reeves G.Frailty is intertwined with heart failure:mechanisms,prevalence,prognosis,assessment,and management[J].JACC Heart Fail,2019,7(12):1001-1011.DOI:10.1016/j.jchf.2019.10.005.
- [16]Buckley BJR,de Koning IA,Harrison SL,et al.Exercise-based cardiac rehabilitation vs.percutaneous coronary intervention for chronic coronary syndrome:impact on morbidity and mortality[J].Eur J Prev Cardiol,2022,29(7):1074-1080.DOI:10.1093/eurjpc/zwab191.
- [17]Heutinck JM,De Koning IA,Vromen T,et al.Impact of a comprehensive cardiac rehabilitation programme versus coronary revascularization in patients with stable angina pectoris:study protocol for the PRO-FIT randomised controlled trial[J].BMCCardiovasc Disord,2023,23(1):238.DOI:10.1186/s12872-023-03266-z.
- [18]Sunamura M,Ter Hoeve N,van den Berg-Emons RJG,et al.Cardiac rehabilitation in patients with acute coronary syndrome with primary percutaneous coronary intervention is associated with improved 10-year survival[J].Eur Heart J Qual Care Clin Outcomes,2018,4(3):168-172.DOI:10.1093/ehjqcco/qcy001.
- [19]Bozkurt B,Fonarow GC,Goldberg LR,et al.Cardiac rehabilitation for patients with heart failure:JACC Expert Panel[J].J Am Coll Cardiol,2021,77(11):1454-1469.DOI:10.1016/j.jacc.2021.01.030.
- [20]Taylor RS,Dalal HM,Zwisler AD,et al.Cardiac rehabilitation for heart failure:‘Cinderella’or evidence-based pillar of care?[J].Eur Heart J,2023,44(17):1511-1518.DOI:10.1093/eurheartj/ehad118.
- [21]Abreu A.Cardiac rehabilitation after acute myocardial infarction:still insufficient referral[J].Int J Cardiol,2018,261:28-29.DOI:10.1016/j.ijcard.2018.03.036.
- [22]Hermann M,Witassek F,Erne P,et al.Referral for cardiac rehabilitation after acute myocardial infarction:Insights from nationwide AMIS Plus registry 2005-2017[J].Int J Cardiol,2018,261:1-5.DOI:10.1016/j.ijcard.2018.01.096.
- [23]Wittboldt S,Leosdottir M,Fischer AR,et al.Exercise-based cardiac rehabilitation after acute myocardial infarction in Swedenstandards,costs,and adherence to European guidelines (The PerfectCR study)[J].Physiotherapy Theory and Practice,2022,1-11.DOI:10.1080/09593985.2022.2114052.
- [24]Lee KCS,Breznen B,Ukhova A,et al.Virtual healthcare solutions for cardiac rehabilitation:a literature review[J].Eur Heart J Digit Health,2023,4(2):99-111.DOI:10.1093/ehjdh/ztad005.
- [25]Rosenfeld A,Ball J,Rattanasithy S.et al.The implementation of a value-based learning health system for preventative care in Ontario,Canada[J].Am J Cardiovasc Dis,2023,13(2):87-100.
- [26]Golbus JR,Lopez-Jimenez F,Barac A,et al.Digital technologies in cardiac rehabilitation:a science advisory from the American Heart Association[J].Circulation,2023,148(1):95-107.DOI:10.1161/CIR.0000000000001150.
- [27]中国医师协会心血管内科医师分会,中国医院协会心脏康复管理专业委员会.慢性冠状动脉综合征患者运动康复分级诊疗中国专家共识[J].中国介入心脏病学杂志,2021,29(7):361-370.DOI:10.3969/j.issn.1004-8812.2021.07.001.
- [28]Peixoto TCA,Begot I,Bolzan DW,et al.Early exercise-based rehabilitation improves health-related quality of life and functional capacity after acute myocardial infarction:a randomized controlled trial[J].Can J Cardiol,2015,31(3):308-313.DOI:10.1016/j.cjca.2014.11.014.
- [29]Shen T,Ren C,Zhao W,et al.Development and validation of a prediction model for cardiovascular events in exercise assessment of coronary heart disease patients after percutaneous coronary intervention[J].Front Cardiovasc Med,2022,9:798446.DOI:10.3389/fcvm.2022.798446.
- [30]Beatty AL,Beckie TM,Dodson J,et al.A new era in cardiac rehabilitation delivery:research gaps,questions,strategies,and priorities[J].Circulation,2023,147(3):254-266.DOI:10.1161/CIRCULATIONAHA.122.061046.