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首页> 外文期刊>Journal of cardiopulmonary rehabilitation >Risk stratification for exercise training in cardiac patients: do the proposed guidelines work?
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Risk stratification for exercise training in cardiac patients: do the proposed guidelines work?

机译：心脏病患者运动训练的风险分层：拟议的指南是否有效？

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PURPOSE: Four authoritative organizations (American Association of Cardiovascular and Pulmonary Rehabilitation [AACVPR], the American College of Cardiology [ACC], the American College of Physicians [ACP], and the American Heart Association [AHA]) have risk stratification guidelines for supervised exercise in patients with cardiovascular disease. The ability of the guidelines to predict exercise complications is untested. METHODS: A prospective sample was evaluated that included 239 patients enrolled for a total of 5720 patient exercise hours in a phase II supervised outpatient cardiac rehabilitation exercise program between December 1, 1992, and June 16, 1995, who had had preprogram stress testing and/or left ventricular ejection fraction determination. Complications during supervised exercise were measured. RESULTS: Overall, 12 patients experienced complications during supervised exercise. None of the guidelines was predictive of complications (positive predictive values, 3-7%). Regression analyses demonstrated that current cigarette smoking was the only predictor of complications. There was reasonable correlation of patient risk stratification among the four guidelines (r = 0.19-0.47; P < 0.0001). CONCLUSIONS: Currently proposed exercise risk stratification guidelines are not predictive of complications during supervised exercise. Further work is needed before exercise risk stratification guidelines are used to adjudicate use of supervised services.
机译：目的：四个权威组织（美国心血管和肺康复协会[AACVPR]，美国心脏病学会[ACC]，美国内科医师学会[ACP]和美国心脏协会[AHA]）具有受监管的风险分层指南心血管疾病患者的运动。该指南预测运动并发症的能力未经测试。方法：评估了一个前瞻性样本，该样本包括1992年12月1日至1995年6月16日进行的II期有监督门诊心脏康复运动计划中总共纳入5720个运动小时的239名患者，这些患者均进行了程序前压力测试和/或确定左心室射血分数。测量监督运动期间的并发症。结果：总体上，有12位患者在有监督的运动中出现并发症。指南均未预测并发症（阳性预测值为3-7％）。回归分析表明，当前吸烟是并发症的唯一预测因素。在这四个指南中，患者风险分层存在合理的相关性（r = 0.19-0.47; P <0.0001）。结论：目前提出的运动风险分层指南不能指导有监督运动期间的并发症。在使用运动风险分层准则来裁定对监督服务的使用之前，需要做进一步的工作。

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