| BackgroundCoronary heart disease(CHD)is still the main cause of high mortality in the world.Due to the application and continuous progress of drug research and development,percutaneous coronary intervention(PCI)and other technologies,the survival rate of CHD patients has been greatly improved.However,the pathological changes of acute and chronic myocardial ischemia or necrosis after severe coronary artery stenosis or occlusion may seriously affect cardiac function,Coronary artery restenosis and ventricular remodeling after PCI are also important factors that further affect the long-term effect of PCI.At present,a large number of randomized controlled trials show that effective rehabilitation exercise training can delay the process of atherosclerosis and reduce the risk factors of coronary heart disease such as arterial hypertension,diabetes,hypercholesterolemia,etc.At the same time,it can improve the blood supply of ischemic myocardium,reduce vascular inflammatory reaction,improve the quality of life of patients,reduce mortality,delay the development of coronary atherosclerosis and improve cardiac function.Because there are still potential risk factors in patients after PCI,some patients have multiple coronary artery disease that cannot or is not suitable for complete recanalization after interventional surgery,there are potential vessels that do not cause severe stenosis but still have unstable plaque,and there is coronary artery disease that may progress,and at the same time,a large number of myocardial cell loss after infarction or ischemia make patients still at high risk.However,because the symptoms of patients with the above diseases are not necessarily obvious and cannot be found in time,it has become an important factor for the high rate of readmission and mortality after PCI.Among high-risk patients,patients with improved peak oxygen uptake and oxygen uptake at anaerobic threshold have higher survival rate.Cardiopulmonary exercise test(CPET)is used to detect potential risks as early as possible,so as to facilitate early and timely detection and intervention,so as to reduce the occurrence of adverse cardiovascular events.This is important for secondary prevention and treatment after PCI.In addition to intensive drug treatment for high-risk patients,current research shows that aerobic exercise can improve cardiac function and reduce the risk of cardiovascular events.However,for high-risk patients,only the precise selection of exercise dose can ensure both the safety of exercise and the effectiveness of treatment.Therefore,the precise choice of exercise therapy dose is crucial and has been under exploration.ObjectiveThe purpose of this study is to explore the improvement of quality of life and cardiac function of patients at high risk after PCI by performing precise exercise dose aerobic exercise under monitoring through retrospective analysis of clinical research,and to explore the selection method of precise dose targeted heart rate for aerobic exercise treatment.MethodAccording to the 2016 Consensus of Experts on Exercise Rehabilitation after Percutaneous Coronary Intervention Therapy,all high-risk patients after PCI in our hospital from January 2019 to December 2019 were included in the study.High-risk patients who were satisfied with more than two follow-up visits from the follow-up clinic of the Department of Cardiology of the China-Japan Friendship Hospital of Jilin University were included in the study.They were divided into rehabilitation treatment group and control group according to whether they completed the precise dose aerobic exercise treatment under supervision.Both groups of patients received standardized drug treatment.Both groups were followed up for one month with CPET to determine whether they were high-risk patients after percutaneous coronary intervention therapy.At the same time,the bull’s-eye rate of the rehabilitation treatment group and the control group was determined according to CPET,and then the precise exercise dose exercise rehabilitation treatment was performed under 6-week monitoring.The control group ordered them to exercise at home.After 6 weeks,the two groups were checked again with CPET to compare the changes of peak oxygen uptake and anaerobic threshold oxygen uptake,Compare the changes of cardiac function according to Weber cardiac function grading,and evaluate the quality of life of patients according to Mac New score.At the same time,cardiac ultrasound was used to evaluate the changes of ejection fraction.The two follow-up visits also included medical history,electrocardiogram and laboratory examination.ResultThe analysis of clinical data between the rehabilitation treatment group and the control group showed that there was no significant difference between the two groups in terms of age,sex,height,body mass index(BMI),blood pressure,fasting blood glucose,low density lipoprotein,left ventricular ejection fraction,etc.Compared with the control group,the rehabilitation treatment group has significantly improved the peak oxygen uptake and anaerobic threshold oxygen uptake after the treatment of aerobic exercise with precise dose target rate under monitoring heart rate and rhythm.According to the Weber cardiac function grading standard,the cardiac function of patients in the rehabilitation treatment group has improved,with significant difference.The quality of life of high-risk patients quantified by Mac New score improved significantly.Conclusion1.The precise exercise dose guided by the target rate under monitoring can improve the peak oxygen uptake and anaerobic threshold oxygen uptake of high-risk patients after PCI.2.Accurate exercise dose aerobic exercise guided by target rate under monitoring can improve cardiac function of high-risk patients after PCI.3.Accurate exercise dose aerobic exercise guided by target rate under monitoring can improve the quality of life of high-risk patients after PCI.To sum up,the precise dose aerobic exercise guided by the bull’s-eye rate under monitoring can improve the quality of life of patients,improve their cardiac function,and reduce the occurrence of adverse events. |
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