Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
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Effects of Cardiac Rehabilitation in Elderly Patients After Myocardial Infarction

노인 심근경색 환자에서의 심장재활의 효과

  • KIM, JI HEE (Department of Physical Medicine and Rehabilitation, Wonkwang University Hospital)
  • 김지희 (원광대학교 의과대학 병원 재활의학과)
  • Received : 2016.06.24
  • Accepted : 2016.09.09
  • Published : 2016.09.30
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Abstract

To investigate the effects of cardiac rehabilitation (CR) on cardiopulmonary exercise capacity in both elderly and younger patients with myocardial infarction (MI). Of the MI patients who received hospital-based CR between February 2012 and December 2015, we retrospectively reviewed the medical records of patients who continued a follow-up through the outpatient clinic. A total of 46 patients (18 elderly patients (${\geq}60years$) and 28 younger patient (< 60)) were included in this study. The subjects visited the clinic to perform aerobic exercises with ECG monitoring based on their initial exercise tolerance test outcome. The exercise capacity was measured by symptom-limited exercise tests before and after hospital-based CR. Before CR, the elderly group had a significantly lower exercise capacity in peak VO2, METs, anaerobic threshold, exercise time, respiratory exchange ratio (RER) than the younger group. After CR, elderly groups showed a significantly improved exercise capacity in exercise time, HRmax, HRrest, peak VO2, METs, anaerobic threshold, and RER. Both elderly and younger groups showed similar improvement of cardiopulmonary exercise capacity after hospital-based CR. There is a very low cardiac rehabilitation participation and referral rates with MI patients in Korea. It is considered necessary to further expand the participation of cardiac rehabilitation in elderly MI patients.

본 연구는 심근경색 환자에서 젊은 환자군과 60세 이상의 노인 환자군에서 심장 재활이 심폐운동 기능에 미치는 효과를 비교하고자 하였다. 2012년에서 2015년까지 심장 재활을 실시하였던 환자 중 외래 경과 관찰중인 환자의 기록을 후향적으로 분석하였다. 총 46명 (60세 이상의 노인 18명, 28명의 60세 미만의 젊은 환자군)이 연구에 포함되었다. 대상자들은 초기 운동부하 검사 결과를 바탕으로 심장재활 치료실에서 심전도 감시 하에 유산소 운동요법을 시행하였다. 심폐기능은 심장재활 실시 전, 후로 운동부하 검사에 의해 평가되었다. 심장재활을 실시하기 전 시행한 운동 부하 검사에서 최대 산소소모량, 최대 운동시의 신진대사 해당치, 무산소 역치 지표 등이 60세 이상의 노인에서 의미 있는 운동 기능 저하가 관찰되었다(p<0.05). 심장재활 전과 후의 운동 능력을 비교하였을 때, 두 군에서 최대 운동 가능시간, 최대하 심근부담률, 최대 심박수, 안정시 심박수, 최대 산소 소모량, 최대 산소소모량 측정시의 최대 환기량, 최대 운동시의 신진대사 해당치, 무산소 역치 지표에서 통계학적으로 유의한 변화가 관찰되어(p<0.05), 심장재활 후 두 군 모두에서 운동기능의 개선의 효과가 있었다. 60세 이상 군과 60세 미만 군 두 군 사이에서 심장재활 전과 후의 운동능력 지표 변화율의 상대적인 비교 시에 최대 운동 가능시간, 최대 산소 소모량, 최대 운동시 신진대사 해당치, 무산소 역치 지표 등의 모든 운동 부하 검사 결과는 유사한 호전을 보였다. 한국에서 노인 환자의 심장재활 참여율과 전과율은 낮은 상태이다. 60세 이상의 노인 환자에서의 심장재활의 참여를 확대하는 것이 필요할 것으로 생각된다.

Keywords

References

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