Koroner arter hastalığı açısından yüksek risk taşıyan hastalarda aerobik egzersiz programının, efor kapasitesi, kan lipit profili, inflamatuar parametreler ve vücut kitle indeksi üzerine etkisi
The effect of an aerobic exercise program on exercise capacity, blood lipid profile, inflammatory parameters, and body mass index in patients at high risk for coronary artery disease
- Tez No: 953099
- Danışmanlar: YRD. DOÇ. DR. GÜLİZ KOZDAĞ
- Tez Türü: Tıpta Uzmanlık
- Konular: Kardiyoloji, Cardiology
- Anahtar Kelimeler: Belirtilmemiş.
- Yıl: 2006
- Dil: Türkçe
- Üniversite: Kocaeli Üniversitesi
- Enstitü: Tıp Fakültesi
- Ana Bilim Dalı: Kardiyoloji Ana Bilim Dalı
- Bilim Dalı: Kardiyoloji Bilim Dalı
- Sayfa Sayısı: 87
Özet
Amac: Kardiak açıdan yüksek riskli hastalarda, 8 haftalık aerobik egzersiz programının, hastaların efor kapasitesine, inflamatuar parametrelere, kan lipit profiline ve vücut kitle indeksine ve Framingham risk skoru üzerine olan etkisini ve beraberinde egzersiz yapmayıp sadece medikal tedavi alan grupla olan farkını araştırmaktır. Gereç ve Yöntem: NCEP ATP III kriterlerine göre kardiyak açıdan yüksek riskli tespit edilen hastalar [koroner arter hastalığı eşdeğeri olan hastalar (diabetes mellitus, periferik arter hastalığı, abdominal aort anevrizması, karotis arter hastalığı)]veya 10 yıllık kardiyak riski ≥% 20 olan hastalar) çalışmanın ayrıntıları anlatılarak ve onay formu alınarak çalışmaya dahil edildi. 25 hasta, 8 hafta boyunca haftanın 3günü 30 dakika aerobik egzersiz programına alınırken, 25 hastada kontrol grubu oldu. Tüm hastalara kılavuzlara uygun medikal tedavileri düzenlendi. Hastaların efor kapasiteleri, çalışma öncesinde ve bitiminde yapılan efor testi ile değerlendirildi. Bulgular: Çalışmaya yaşları 50-72 arasında değişen (ortalama yas 61±yil),40'ı kadın (%80), 10'u erkek (%20) toplam 50 hasta alindi. Egzersiz grubundaki hastalarda, 8. Hafta sonrasında toplam kilolarında (p
Özet (Çeviri)
Objective: To determine the effects of 8 weeks aerobic exercise program on the exercise capacity, inflammatory parameters, blood lipid profile, body mass index and Framingham risk score in patients with high cardiac risk and the differences from the patients treated only with medical therapy. Method: The patients with high cardiac risk according to NCEP ATP III criteria (coronary artery disease equivalent: diabetes mellitus, peripheral artery disease, abdominal aorta aneurysms, carotid artery disease) or patients with 10-year cardiac risk≥%20 were studied. Twenty-five patients were included to aerobic exercise program for 30 minutes/day for 3 days in a week. The aerobic exercises were programmed as 8 weeks. There were 25 patients in the control group. Medical treatment was given to all patients according to the guidelines. The exercise capacities of the patients were determined with exercise stress tests which were done before and at the end of study. Results: Fifty patients were studied (% 80 women, % 20 men). Their ages were varied between 50-72 years and the mean age was 61 ± 5 years. In patients with exercise group; the body weight, the waist and hip circumferences, and body mass index were decreased significantly after 8 weeks. These parameters in exercise group; patients were improved better compared to control group. In exercise group; significant decrease in LDL cholesterol, total cholesterol, triglyceride levels and an increase in HDL cholesterol were observed compared to basal levels. Although high sensitive CRP levels were decreased in both group, a much more decrease was observed in exercise group. Homoscysteine and fibrinogen levels were not changed in control group, but a significant decrease was seen in aerobic exercise program group. Fasting blood glucose, insulin and HbA1c levels were decreased significantly in the aerobic exercise program group; but these parameters were not changed in the control group. The exercise capacities of the patients in the exercise program were determined with exercise stress test at the end of study. The exercise capacities and total MET values were increased significantly. The cardiac risk index calculated according to Framingham risk score were decreased significantly in each group at the end of study. Any significant difference was not found between these two groups in risk reduction. Conclusion: There was a significant decrease in body mass indexes, waist and hip circumferences of the patients in aerobic exercise program group. The blood lipid profile, inflammatory parameters, diabetes related parameters were improved significantly compared to control group. The exercise capacities of the patients in aerobic exercise group were improved compared to basal levels. In this study, we have shown that regular aerobic exercise which is effective and safe, can be suggested to the patients with high 10-year cardiac event risk in addition to medical therapy to decrease the probable cardiovascular events.
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