成人Fontan患者的在线康复：对功能、淋巴功能和生活质量的影响。

IF 3.2 2区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

International journal of cardiology Pub Date : 2025-06-05 DOI:10.1016/j.ijcard.2025.133480

Aida Luiza Ribeiro Turquetto , Luciana Patrick Amato , Lene Thorup , Benjamin Kelly , Vibeke Elizabeth Hjortdal , Francis Ribeiro de Souza , Luiz Fernando Canêo , Desiree S. Machado , Antonio Carlos Battaglia Filho , Melissa Ganeko Ligeiro , Sheyanth Mohanakumar , Eduardo Rondon , Maria Angélica Binotto , Marcelo Biscegli Jatene , Fabio Biscegli Jatene

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引用次数: 0

摘要

前言：fontan后患者的生存率有所提高，使许多人能够以更好的生活质量（QOL）进入成年期。然而，他们仍然存在功能容量降低（FC）、骨骼肌损失和淋巴功能障碍的风险，这对临床结果产生负面影响。本研究评估了成人Fontan患者术后后期在线康复方案的可行性及其对FC、外周淋巴功能（PLF）和生活质量的影响。方法：这项前瞻性、非随机、对照临床试验评估了健身中心36期在线有氧和阻力训练计划的影响。参与者被分为对照组（CG），继续日常活动组和锻炼组（EG）。结果包括生活质量（SF-36问卷：SF-36），通过心肺运动测试（CPET）的FC，以及使用近红外荧光成像和静脉闭塞容积描记术评估的PLF。结果：共纳入26例受试者（EG 13例，CG 13例），中位年龄为30（25-35）岁，Fontan后随访时间为19（15-21）年。EG显示峰值VO2 （ml/kg/min）、预测峰值VO2（%）、峰值通气量（L/min）和氧脉冲（ml/ beat）显著改善，表明心血管效率提高。此外，62% %的SF-36结构域在EG中得到改善，而在CG中没有观察到变化。然而，该程序并没有对PLF产生显著的改变。结论：提出的在线康复方案被证明是可行的，有效地改善了Fontan手术后成人的FC和生活质量；然而，这种训练模式对周围淋巴功能没有显著影响。

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Online rehabilitation in adult Fontan patients: Effects in functional capacity, lymphatic function and quality of life

Introduction

Survival rates for post-Fontan patients have improved, allowing many to reach adulthood with better quality of life (QOL). However, they remain at risk for reduced functional capacity (FC), skeletal muscle loss, and lymphatic dysfunction, which negatively affect clinical outcomes. This study evaluated the feasibility of an online rehabilitation program for adult Fontan patients in the late postoperative period and its effects on FC, peripheral lymphatic function (PLF), and QOL.

Methods

This prospective, non-randomized, controlled clinical trial evaluated the impact of a fitness center's 36-session online aerobic and resistance training program. Participants were divided into a control group (CG), continuing usual activities, and an exercise group (EG). Outcomes included QOL (Short Form-36 questionnaire: SF-36), FC via cardiopulmonary exercise testing (CPET), and PLF assessed using near-infrared fluorescence imaging and venous occlusion plethysmography.

Results

A total of 26 participants (13 EG,13 CG), with a median age of 30 (25–35) years, and follow-up time after Fontan of 19 (15–21) years, were enrolled. The EG showed significant improvements in peak VO2 (ml/kg/min), predicted peak VO2 (%), peak ventilation (L/min), and oxygen pulse (mL/beat), indicating enhanced cardiovascular efficiency. Additionally, 62 % of SF-36 domains improved in the EG, while no changes were observed in the CG. However, the program did not produce significant modifications in PLF.

Conclusions

The proposed online rehabilitation program proved to be feasible and effectively improved FC and quality of life in adults after Fontan surgery; however, this training model did not significantly influence peripheral lymphatic function.

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来源期刊

International journal of cardiology 医学-心血管系统

CiteScore

6.80

自引率

5.70%

发文量

758

审稿时长

44 days

期刊介绍： The International Journal of Cardiology is devoted to cardiology in the broadest sense. Both basic research and clinical papers can be submitted. The journal serves the interest of both practicing clinicians and researchers. In addition to original papers, we are launching a range of new manuscript types, including Consensus and Position Papers, Systematic Reviews, Meta-analyses, and Short communications. Case reports are no longer acceptable. Controversial techniques, issues on health policy and social medicine are discussed and serve as useful tools for encouraging debate.