心肺运动测试指导心脏康复联合正念认知疗法对老年慢性心力衰竭患者心肺功能、焦虑抑郁情绪和预后的影响.

Objective: To observe the effects of cardiopulmonary exercise test（CPET） guided cardiac rehabilitation combined with mindfulness-based cognitive therapy（MBCT） on cardiopulmonary function, anxiety, depression and prognosis in elderly patients with chronic heart failure（CHF）. Methods: 156 elderly patients with CHF who were treated in the Geriatric Department of the Fourth Medical Center of PLA General Hospital from August 2018 to May 2020 were selected. According to the two-color ball method, the patients were divided into control group（78 cases, receiving CPET guided cardiac rehabilitation intervention on the basis of routine treatment） and observation group（78 cases, combined with MBCT intervention on the basis of control group）. The changes of cardiopulmonary function, anxiety and depression and prognosis of patients in both groups were observed. Results: The carbon dioxide ventilation equivalent slope（VE/VCO2slop）, left ventricular end diastolic diameter（LVEDD） in two groups after intervention decreased. Peak oxygen consumption（peak VO2）, anaerobic threshold oxygen consumption（VO2AT）, left ventricular ejection fraction（LVEF） after intervention increased（P<0.05）. VE/VCO2slop, LVEDD in the observation group after intervention were lower than those in the control group, and peakVO2, VO2AT, LVEF were higher than those in the control group（P<0.05）. The scores of 17 items of Hamilton Depression Scale（HAMD-17） and Hamilton Anxiety Scale（HAMA） in the two groups after intervention decreased（P<0.05）. The scores of HAMD-17 and HAMA in the observation group after intervention were lower than those in the control group（P<0.05）. The rehospitalization rate within one year and mortality within one year in the observation group were lower than those in the control group（P<0.05）. Conclusion: CPET guided cardiac rehabilitation combined with MBCT in the treatment of elderly patients with CHF can promote the recovery of cardiopulmonary function, improve anxiety and depression, and reduce the rehospitalization rate within one year and mortality within one year. [ABSTRACT FROM AUTHOR]