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학술저널
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박찬수 (서울대학교) 박진주 (서울대학교) 오일영 (서울대학교) 윤창환 (서울대학교) 최동주 (서울대학교) 박현아 (인제대학교) 강석민 (연세대학교) 유병수 (연세대학교) 전은석 (성균관대학교) 김재중 (울산대학교) 조명찬 (충북대학교) 채성철 (경북대학교) 유규형 (한림대학교) 오병희 (서울대학교) behalf of the KorHF Investigators (behalf of the KorHF Investigators)
저널정보
대한심장학회 Korean Circulation Journal Korean Circulation Journal Vol.47 No.5
발행연도
2017.1
수록면
727 - 741 (15page)

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Background and Objectives Although many clinical trials have shown that exercise training (ET) improves functional capacity and clinical outcomes in heart failure (HF) patients, data comparing supervised hospital-based and educated home-based ET in HF patients is lacking. Subjects and Methods This was a single-center, non-randomized, prospective study of 82 HF patients with reduced ejection fraction (≤40%) who completed ET. The hospital-based group (n=30) underwent supervised ET at 60% of peak oxygen consumption (VO2), while a physiotherapist-educated group (n=52) exercised at home without monitoring. The 2 groups were compared before and after the 3-month ET program with respect to functional capacity, quality of life (QOL), and cardiac events (all-cause mortality or hospitalization with worsening HF). Results After ET, peak VO2 increased in the hospital-based group (19.4±4.4 to 21.4±4.3 mL/min/kg, p=0.006) and remained unchanged in the home-based group (18.9±4.6 to 18.4±4.6 mL/min/kg, p=0.660). The change in peak VO2 after ET was greater in the hospital-based group compared to the home-based group by 2.5 mL/min/kg (p=0.014). QOL improved in the hospital-based group (43.1±18.0 to 28.1±21.6, p=0.003). During one year of follow-up, a comparison of the 2 groups did not reveal a statistical difference in cardiac events (hazard ratio, 0.66; 95% confidence interval, 0.2–2.8; p=0.570). Conclusion Hospital-based ET was beneficial for HF patients, improving functional capacity and QOL. However, no significant advantages were observed in terms of a composite endpoint compared to home-based ET. Further investigations are required to address the effects and roles of the 2 ET programs for HF patients

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