心脏再同步化治疗患者的运动康复研究进展

Research Progress in Exercise Rehabilitation in Patients Undergoing Cardiac Resynchronization Therapy

慢性心力衰竭(CHF)是指由各种心脏结构或功能异常导致心室充盈和(或)射血能力受损而引起的一组临床综合征,是心血管疾病最主要的死因。部分患者因心肌细胞病理性变化出现心脏电-机械活动失同步,致使有效心排量降低,严重威胁患者生命安全。心脏再同步化治疗(CRT)通过植入电极纠正心脏收缩失同步,恢复房室、室间和(或)室内协调收缩功,改善CHF患者临床症状。运动康复作为心脏康复的核心内容,已被证实可提高心力衰竭患者CRT术后的运动耐力和生活质量。文章对心脏再同步化治疗患者运动康复的内容、应用效果及安全性进行综述,以期为心脏再同步化治疗设备植入患者运动康复方案的制定及临床实践提供参考。

Chronic heart failure(CHF),a leading cause of death from cardiovascular diseases,refers to a group of clinical syndromes caused by various structural or functional cardiac abnormalitiesresulting in impaired ventricular filling and(or)ejection capacity.Some CHF patients suffer from electromechanical asynchrony due to pathological changes in cardiac myocytes,which leads to a decrease in effective cardiac output and seriously threatens the lives of patients.Cardiac resynchronization therapy(CRT)corrects cardiac contractile asynchrony by implanting electrodes to restore atrioventricular,interventricular and(or)intraventricular coordinated systolic work,and improves clinical symptoms in CHF patients.As the core content of cardiac rehabilitation,exercise rehabilitation has been proved to improve exercise endurance and quality of life after CRT in patients with CHF.This article summarizes the content,efficacy and safety of exercise rehabilitation in patients undergoing CRT,in order to provide reference for the formulation and clinical practice of exercise rehabilitation programs in patients with CRT equipment implantation.