虚拟现实技术在心脏康复患者中的应用进展

在心血管疾病二级预防中心脏康复能降低13％～24％的患者总病死率和31％的1年内再入院率,是心血管疾病防治的Ⅰ级推荐.虚拟现实技术能帮助打破传统心脏康复时间、地域与交通的限制,提高患者心脏康复的参与度,成为心脏康复的有效辅助手段.该文综述了心脏康复虚拟现实技术的发展、技术类型、使用方法、注意事项和应用效果等,为我国开发...     

运动训练治疗慢性心力衰竭的研究进展

心脏康复有助于改善心血管疾病患者的心功能已成为临床共识,运动训练是心脏康复的核心,其中运动训练对慢性心力衰竭（CHF）患者的治疗作用也逐渐被认可。本文对运动训练治疗的研究进行综述,着重阐述运动训练在中的作用机制、具体适合对象、实施方案,为的治疗提供新的思路。     

运动疗法应用于急性心肌梗死早期心脏康复的研究进展

21世纪随着生活水平的不断提高及生活方式的改变,冠心病、急性心肌梗死（AMI）等心血管疾病的发病率也随之增加。心脏康复在近代心血管疾病预防和治疗成为康复医学的重要组成部分。心脏康复可提高患者对治疗的依从性,提高心脏功能,改善生活质量,降低病死率。现就近年运动疗法在AMI早期心脏康复的研究综述如下。     

心脏康复评估内容与方法

心脏康复是为心血管疾病和高危患者提供的个体化预防和治疗方法。其中,心脏康复评估是个体化治疗有效与否非常重要的前提保证。该文系统介绍了心脏康复评估中需要的各项评估内容和工具,供临床工作者参考。     

心脏运动康复的发展现状及影响因素的研究进展

正心血管疾病病死率位居全球首位~[1],高于恶性肿瘤,对人类的身心健康造成严重的威胁。心脏康复作为一种综合的治疗方式应运而生,通过精准康复管理,有效改善心血管疾病患者的预后,成为了冠心病的治疗手段~[2]。运动康复是心脏康复的核心内容,有大量研究表明,长期坚持参与运动训练,可降低心血管疾病的复发率和死亡率,改善血管内皮功能及心功能,缓解患者的焦虑、抑郁情绪,提高患者     

心脏磁共振成像在妊娠合并心脏疾病中的应用研究进展

心脏疾病导致怀孕的风险升高。女性妊娠期的特征是多器官、多系统的变化,诊断过程中要考虑胎儿的安全。心脏磁共振(CMR)成像具有无辐射、无创伤等优势,不仅能够很好地显示心脏结构、功能、心肌组织特征、血流、心肌瘢痕及纤维化灶,而且可以对疾病的危险分层、预后等提供依据。目前,CMR在先天性心脏病、心脏瓣膜病、冠状动脉疾病、心肌病等心血管疾病中发挥着越来越重要的作用。本研究对CMR在妊娠合并心脏疾病女性中的应用进展进行综述。     

运动康复治疗在心血管疾病中的机制研究

近年来,心血管疾病的发病率呈逐年升高趋势,其中冠心病、心力衰竭等具有病程长、致死率高的特点,严重影响患者的生存质量。运动康复治疗可有效改善患者生存质量,降低住院率及病死率。运动康复治疗对心血管疾病的作用较为复杂,可对冠心病、心力衰竭等患者带来不同程度的获益。目前,心脏运动康复治疗相关机制的研究较多,本文从心脏血管适应和心肌细胞适应2个方面总结了心脏康复治疗的最新相关机制研究进展,其内容涉及血管内皮功能、侧支形成、血小板抑制、心肌代谢、心肌兴奋耦联收缩、心肌电重构等,以期为心血管疾病的康复治疗方案提供依据。     

超觉静坐训练对居家心脏康复作用的研究进展

超觉静坐训练(TM)是一种压力管理策略，可有效减少心血管事件风险、改善生活质量。其在居家心脏康复(HBCR)中的作用逐渐凸显。TM与脑区、免疫功能及自主神经系统密切相关，表现为对心血管危险因素管理、结构功能改变及预防的效果等，在心脏康复过程中发挥着重要作用。文章介绍TM的概念、处方及优势，重点阐述TM对HBCR的作用机制、作用效果，并总结其发展前景。     

增强型体外反搏治疗的临床应用及护理

增强型体外反搏(enhanced external counter-pulsation,EECP)是采用无创伤性辅助循环的方法进行治疗。EECP对缺血性疾病是一种有效的治疗方法,其独特之处是在无创伤、轻松、舒适中进行血管内血流加速运动。Linnemeier报道很多医院应用EECP治疗缺血性心脑血管等疾患     

逍遥散在冠心病康复双心医学治疗中运用

<正>在冠心病的治疗过程中,康复治疗有着极其重要的作用,而双心医学治疗理念是除了治疗患者生理上的病症以外,还要治疗患者心理疾病或心理障碍,正符合心脏心理康复理念。中医运用独特的辨证论治体系,辨证使用逍遥散,对冠心病合并心理疾病的患者,有独特的疗效。心脏康复的重要性近年来,我国心血管疾病的患病率及死亡率不断攀升,《中国心血管病报告2015》显示心血管病占居     

太极拳在冠心病心脏康复中的研究进展

太极拳秉承了中国古代哲学阴阳辨证及道教“太极”理念,又暗合中医阴阳五行及经络学说思想,长期锻炼有益于人的身心健康。近年来关于太极拳在冠心病心脏康复中的一系列研究表明,太极拳运动不仅减轻冠心病患者临床症状,提高生活质量,并且有效干预冠心病危险因素如高血压、高血脂、高血糖,改善不良情绪,延缓动脉粥样硬化,修复血管内皮功能,调控心脏自主神经,降低心血管事件的再发率,改善冠心病患者的远期预后。     

康复路径基于专科护士为导向的延续护理在急性心肌梗死患者心脏康复中的应用

目的:探讨康复路径结合基于专科护士为导向的延续护理在急性心肌梗死患者心脏康复中应用。方法:选取2017年8月至2018年8月华中科技大学同济医学院附属同济医院收治的急性心肌梗死患者102例,随机分为两组,对照组应用常规干预,研究组应用康复路径基于专科护士为导向的延续护理。观察并比较两组干预后恢复情况、住院期间卧床时间及平均住院时间、出院后相关心血管不良事件发生情况及出院后不同时间点下的运动耐力情况。结果:研究组心功能分级情况、左心室射血分数(LVEF)水平恢复情况、改良Barthel指数(MBI)评分、卧床时间及平均住院时间、出院后随访期间的相关心血管不良事件发生比例、不同时间点下运动耐力情况均显著优于对照组,差异有统计学意义(均 P<0.05)。 结论:急性心肌梗死患者心脏康复过程中应用康复路径基于专科护士为导向的延续护理,能有效缩短患者的住院时间、改善患者的心功能分级与LVEF水平,同时有效降低患者出院后发生相关心血管不良事件风险。     

心脏康复护理专家共识

目的形成《心脏康复护理专家共识》（以下简称《共识》）,规范医疗机构心脏康复护理相关工作。方法 在全面回顾国内外心脏康复相关指南、专家共识、系统评价、原始研究等文献及相关疾病诊疗方案、管理共识等相关文献的基础上,形成《共识》初稿,并邀请心血管领域的临床护理、医疗以及护理管理等相关领域专家开展专家论证。结果 共邀请37名专家开展了3轮专家论证,对初稿进行修改和完善,形成终版《共识》,包括心脏康复护理工作目标,心脏康复护士资质、培训、核心能力与职责,心脏康复护理工作内容,心脏康复护理质量管理,心脏康复患者安全管理5个方面。结论 《共识》是在综合专家意见及心脏康复相关指南、共识及临床研究基础上形成,可为医疗机构开展心脏康复护理工作提供参考。     

Crosstalk between mitogen-activated protein kinases and mitochondria in cardiac diseases: Therapeutic perspectives

Cardiovascular diseases cause more mortality and morbidity worldwide than any other diseases. Although many intracellular signaling pathways influence cardiac physiology and pathology, the mitogen-activated protein kinase (MAPK) family has garnered significant attention because of its vast implications in signaling and crosstalk with other signaling networks. The extensively studied MAPKs ERK1/2, p38, JNK, and ERK5, demonstrate unique intracellular signaling mechanisms, responding to a myriad of mitogens and stressors and influencing the signaling of cardiac development, metabolism, performance, and pathogenesis. Definitive relationships between MAPK signaling and cardiac dysfunction remain elusive, despite 30 years of extensive clinical studies and basic research of various animal/cell models, severities of stress, and types of stimuli. Still, several studies have proven the importance of MAPK crosstalk with mitochondria, powerhouses of the cell that provide over 80% of ATP for normal cardiomyocyte function and play a crucial role in cell death. Although many questions remain unanswered, there exists enough evidence to consider the possibility of targeting MAPK–mitochondria interactions in the prevention and treatment of heart disease. The goal of this review is to integrate previous studies into a discussion of MAPKs and MAPK–mitochondria signaling in cardiac diseases, such as myocardial infarction (ischemia), hypertrophy and heart failure. A comprehensive understanding of relevant molecular mechanisms, as well as challenges for studies in this area, will facilitate the development of new pharmacological agents and genetic manipulations for therapy of cardiovascular diseases.     

Remotely monitored telerehabilitation for cardiac patients: A review of the current situation

Cardiac rehabilitation through center-based programs is an effective multicomponent intervention for the secondary prevention of cardiovascular diseases. Despite the benefits it brings, patients’ participation in rehabilitation programs remains low. In this work, the latest relevant literature regarding remotely monitored cardiac telerehabilitation (TR) was reviewed considering its efficiency and utilization. The main objective was to assess whether TR has the potential to be an appropriate alternative form of rehabilitation. A total of 105 publications on this topic were screened out of 747 full-text articles that were read and evaluated, of which 12 were considered suitable for inclusion in the final review. Feasibility, efficiency, and safety were assessed for each TR intervention. The results of our evaluation indicate that TR seems to be a usable, effective, and safe alternative rehabilitation for patients with heart disease. Most of the currently published articles have studied remotely monitored TR intervention offering a comprehensive approach, which indicates the significant development and steps forward in this field of study. Our research evidence supports the implementation of TR, which could positively influence barriers in participating in cardiac rehabilitation programs.     

The prevalence of erectile dysfunction in men attending cardiac rehabilitation: an audit in East London

The aim of this study was to ascertain the prevalence of erectile dysfunction (ED), how it is perceived and the percentage seeking treatment for the condition in a population of men with cardiovascular disease (CVD) attending a cardiac rehabilitation programme in East London, UK. One hundred male subjects aged between 30 and 88 years attending a cardiac rehabilitation centre in East London participated in the study. An audit of men attending a cardiac rehabilitation programme was conducted. Participants completed the International Index of Erectile Function (IIEF‐5) to ascertain the severity of ED, an adapted ‘bother score’ item from the International Prostate Symptom Score (IPSS) to investigate the extent to which participants were bothered by the symptoms of their ED and questions related to both ED treatment‐seeking and beliefs about the impact of cardiac medication on ED. Demographic and clinical data were also collected. The audit was carried out between January and September 2014. Out of 117 male participants, 100 were audited (85·5% uptake). Prevalence of ED in this cohort was 80%, and 38% were suffering with moderate or severe ED. Older men had significantly higher levels of ED, and participants with severe ED were significantly more bothered by their condition. Those of Asian or British Asian descent reported significantly higher levels of ED severity than men from white ethnic backgrounds. Sixty‐five percent of men with ED had never spoken to a health care professional (HCP) about the condition, and 35% believed that their medication had a deleterious effect on erectile function. High incidences of ED remain undetected in this patient population. The study stresses the importance for HCPs to discuss ED with patients within primary care and cardiac rehabilitation programmes, which in turn could reduce mortality in those at risk of a future cardiac event as well as facilitate access to ED treatment.     

心脏康复研究的最新进展

心脏康复医学是一门发展中的科学,它的理论与实践处于起步阶段,为适应心血管医学发展的需求,要掌握心脏临床医学的发展动向,并突出本学科特点的优势,发展成为心血管医学中重要的组成部分。心脏康复的研究有着广阔的应用前途,其研究成果将丰富康复医学和心血管临床医学。     

Perceptions of illness as predictive factors for perceived stress in patients participating in a cardiac rehabilitation program

Psychosocial risk factors, such as perceived stress, not only increase the risk of cardiovascular disease, but also act as barriers for treatment adherence and cardiac rehabilitation. In this study, we examined the predictive role of perceptions for illness to perceived stress in Iranian patients participating in a cardiac rehabilitation program. A cross‐sectional study was conducted in 2017 to determine correlations of demographic variables and domains of illness perception with perceived stress, and to develop a predictive model for perceived stress. In total, 150 patients with cardiovascular disease, who were admitted to a cardiac rehabilitation center, completed the questionnaires. (i) demographic and health‐related characteristics; (ii) the Perceived Stress Scale‐14; and (iii) the Brief Illness Perception Questionnaire. The mean perceived stress was 16.2 (8.4), and five illness perception subscales – timeline, personal control, treatment control, understanding and emotional response – were associated with increased perceived stress. Variables in the multi‐variate predictive model accounted for 48% of the total variance in perceived stress. The results demonstrated the value of assessing and managing the patients' perceptions of illness to reduce their perceived stress, which could support adherence to cardiac rehabilitation programs.     

Acute and chronic hemodynamic effects of enhanced external counterpulsation in patients with angina pectoris.

BACKGROUND: Enhanced external counterpulsation (EECP) is an effective noninvasive treatment for patients with angina pectoris. However, the hemodynamic effects of EECP are still unknown and have been theorized to simulate the clinical use of the intra-aortic balloon pump, enhancing cardiac output, stroke volume, and retrograde aortic diastolic flow. METHODS: Twelve hemodynamic parameters were measured, using the BioZ System (CardioDynamics International Corporation, San Diego, Calif) after 1 hour (n=22) and after 35 hours (n=16) of EECP treatment compared with baseline. The BioZ System noninvasively measures hemodynamic parameters using the thoracic electrical bioimpedance method. RESULTS: One hour of EECP treatment revealed a significant decrease in cardiac output, stroke volume, contractility, afterload, preload, and myocardial energy production, but systolic time ratios and thoracic fluid content were unchanged. However, after 35 hours of therapy, stroke volume (P < or = 0.05), index of contractility (P < or = 0.05), and thoracic fluid content (P < or = 0.01) were decreased. CONCLUSIONS: The acute reduction in contractility, preload, and concurrent bradycardia may have favorable hemodynamic effects for patients with angina pectoris. Further studies are needed to elucidate the mechanism of EECP therapy and its efficacy for patients with angina pectoris.