心脏康复后女性心肺功能的改善因体重指数类别而异

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

CJC Open Pub Date : 2025-04-01 DOI:10.1016/j.cjco.2024.12.007

Heather E. Conradson RN, PhD , Daniele Chirico PhD , Kathryn King-Shier RN, PhD, FESC , Codie Rouleau RPsych PhD , Tavis S. Campbell PhD , Sandeep Aggarwal MD, FRCPC , Ross Arena PhD , Trina Hauer MSc , Stephen B. Wilton MD, MSc , Tamara M. Williamson PhD

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引用次数: 0

摘要

背景：改善女性心血管结局需要优化心肺适能（CRF），因为较高的CRF预示着心血管疾病（CVD）患者死亡率的改善。因此，增加CRF是心脏康复（CR）的关键目标。本研究通过体重指数（BMI）评估身体体质对心血管疾病女性患者CRF改善的潜在影响。方法：在1996年至2016年期间完成12周基于运动的CR计划的诊断为CVD的女性（18岁以上）纳入本回顾性分析。女性在CR前和CR完成时完成了症状受限的分级运动测试，通过峰值代谢当量（METs）来确定CRF。根据基线BMI对女性进行分类：正常= 18.5至24.9 kg/m2，超重= 25.0至29.9 kg/m2，肥胖≥30 kg/m2。采用混合协方差分析（ANCOVA）评估12周时BMI分级对ΔMETs的影响。结果1313名女性（平均年龄62±11岁）的数据被分析。混合ANCOVA结果显示BMI类别相互作用的显著时间（cr前，12周）（F [2,1307] = 3.20, P = 0.041， ƞp2 = 0.005）。随访方差分析（ANOVAs）显示，BMI正常和超重女性的ΔMETs有显著改善(标准平均差异分别为1.03,n = 454和0.92,n = 461, P <；0.001)。然而，使用Bonferroni-adjusted alpha = 0.017， ΔMETs在被归类为肥胖的女性中是不显著的(标准化平均差[SMD] = 0.79, P = 0.028；N = 398)。结论：一个为期12周的以运动为基础的CR计划增加了BMI分类为正常或超重的女性的CRF，而肥胖女性没有实现类似的改善。肥胖女性可能需要量身定制的策略来提高cr中CRF的改善。

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Women’s Improvements in Cardiorespiratory Fitness Following Cardiac Rehabilitation Differ by Body Mass Index Category

Background

Improving women’s cardiovascular outcomes requires optimizing cardiorespiratory fitness (CRF), as higher CRF predicts improved mortality in people with cardiovascular disease (CVD). As such, increasing CRF is a key goal of cardiac rehabilitation (CR). This study assesses the potential influence of body habitus, assessed by body mass index (BMI), on improvements in CRF in women with CVD.

Methods

Women (18+ years) diagnosed with CVD who completed a 12-week exercise-based CR program between 1996 and 2016 were included in this retrospective analysis. Women completed a symptom-limited graded exercise test before CR and at CR completion to determine CRF via peak metabolic equivalents (METs). Women were categorized by baseline BMI: normal = 18.5 to 24.9 kg/m², overweight = 25.0 to 29.9 kg/m², and obese ≥ 30 kg/m². Mixed analysis of covariance (ANCOVA) was performed to evaluate the impact of BMI classification on ΔMETs at 12 weeks.

Results

Data from 1313 women (mean age = 62 ± 11 years) were analyzed. Results from mixed ANCOVA indicated a significant time (pre-CR, 12 weeks) by BMI category interaction (F [2,1307] = 3.20, P = 0.041, ƞp² = 0.005). Follow-up analyses of variance (ANOVAs) showed significant improvements in ΔMETs in women with normal and overweight BMI categories (standard mean difference =1.03, n = 454 and 0.92, n = 461, respectively, P < 0.001). However, ΔMETs among women classified as obese was nonsignificant using a Bonferroni-adjusted alpha of 0.017 (standardized mean difference [SMD] = 0.79, P = 0.028; n = 398).

Conclusions

A 12-week exercise-based CR program increased CRF in women classified as normal or overweight by BMI, whereas those with obesity did not realize similar improvements. Women with obesity may need tailored strategies to increase their improvements in CRF in CR.