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Plos Med:每周进行170-240分钟运动,房颤患者或可获得很大心血管益处

2021-06-13 MedSci原创 MedSci原创

房颤(AF)是最常见的心律失常之一,在过去的几十年里,其发病率一直在持续增长。多项研究显示,AF与中风、心力衰竭、心肌梗死和死亡风险增加相关。据数据统计,AF 不仅增加了医疗负担,还大大降低了患者的生

房颤(AF)是最常见的心律失常之一,在过去的几十年里,其发病率一直在持续增长。多项研究显示,AF与中风、心力衰竭、心肌梗死和死亡风险增加相关。据数据统计,AF 不仅增加了医疗负担,还大大降低了患者的生活质量,因此提倡将 AF 的综合管理作为整体护理的一部分。

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AF 危险因素的管理中,定期进行中等强度的运动,不仅可以改善相关血管疾病,还可改善AF的复发率,进而提高患者生活质量。尽管运动和AF相关结果之间的联系已经得到了大量证据的支持,然而,目前没有研究数据表明运动与 AF 患者心血管发病率之间的关联。

鉴于新诊断AF 患者与运动习惯改变有关的心血管结果的信息很少,近日,发表在Plos Med杂志的一项研究,调查了新诊断为AF 的患者,运动习惯与缺血性中风、心力衰竭和全因死亡风险之间的关系。

在这项队列研究中,研究人员使用了来自韩国国家健康保险服务的数据,对2010年至2016年间新诊断为AF66692名患者进行了回顾性分析。这些患者在AF诊断前后2年内接受了2次连续的健康检查。通过问卷调查的形式,收集了AF在诊断前后2年内的锻炼情况,并分为4类:持续不锻炼者(30.5%)、新锻炼者(17.8%)、锻炼放弃者(17.4%)和锻炼保持者(34.2%。考虑到人口统计学、合并症、药物、生活方式行为和收入状况,各组之间的基线特征差异进行平衡。在3.4±2.0年平均随访期内,通过Cox模型对结果进行评估。

结果显示,与持续不锻炼者相比,运动者和运动维持者患心力衰竭风险较低,危险比(HRs)分别为0.950.92P < 0.001)。另外,与持续不锻炼相比,在房颤诊断前后的任何时候进行锻炼都与较低的死亡风险有关。锻炼者的HR0.82,放弃锻炼者为0.83,维持锻炼者为0.61P < 0.001)。对于缺血性卒中,锻炼者的 HR 估计值低 10%–14%,但差异无统计学意义(p =0.057)。

 

运动状态对缺血性卒中、心力衰竭和全因死亡风险比的影响.

研究人员进一步对锻炼者亚组分析发现,定期适度锻炼 170–240分钟/周的能量消耗始终与每个结果的较低风险相关。因此,将运动作为一种生活方式对 AF 患者进行干预,对其心血管预后有着潜在益处。

综上,在这项全国性的队列研究中,AF诊断后开始或继续定期运动与较低的心力衰竭和死亡风险有关。定期适度运动170-240分钟/周可能是在房颤诊断后开始运动的患者获得最大心血管益处,但需要进一步的前瞻性研究来确定最佳能量消耗。

原始出处

Hyo-Jeong Ahn ,So-Ryoung Lee ,et al.Association between exercise habits and stroke, heart failure, and mortality in Korean patients with incident atrial fibrillation: A nationwide population-based cohort study.Plos Med. https://doi.org/10.1371/journal.pmed.1003659

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    2021-06-15 ms6000000800992147

    运动可以给房颤患者带来心血管获益

    0

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    2021-06-14 ms9000000883963153

    十分有帮助

    0

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    2021-06-13 心介

    房颤,临床上碰到很多哦

    0

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