BACKGROUND Recent evidence suggests that routine exercise-based cardiac rehabilitation (CR) may not lead to a substantial increase in estimated peak oxygen uptake (V̇O2peak). This could reduce the potential benefits of CR and explain why CR no longer improves patient survival in recent studies. We aimed to determine whether routine exercise-based CR increases V̇O2peak using gold-standard maximal cardiopulmonary exercise testing (CPET), and to quantify the exercise training stimulus which might be insufficient in patients undertaking CR. METHODS We studied the effects of a routine, twice weekly, exercise-based CR programme for eight weeks (intervention group) compared with abstention from supervised exercise training (control group) in patients with coronary heart disease. The primary outcome was V̇O2peak measured using CPET. We also measured changes in body composition using dual X-ray absorptiometry, carotid intima-media thickness, hs-CRP and N-terminal pro B-type natriuretic peptide at baseline, 10 weeks and 12 months. We also calculated the Calibre 5-year all-cause mortality risk score. RESULTS Seventy patients (age 63.1 SD10.0 years; BMI 29.2 SD4.0 kg·m-2; 86% male) were recruited (n = 48 intervention; n = 22 controls). The mean aerobic exercise training duration was 23 min per training session, and the mean exercise training intensity was 45.9% of heart rate reserve. V̇O2peak was 23·3 ml·kg-1·min-1 at baseline, and there were no changes in V̇O2peak between groups at any time point. The intervention had no effect on any of the secondary endpoints. CONCLUSION Routine CR does not lead to an increase in V̇O2peak and is unlikely to improve long-term physiological outcomes.

中文翻译：

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基于常规运动的心脏康复不会增加有氧健身：一项CARE CR研究。

背景技术最近的证据表明，基于常规运动的心脏康复（CR）可能不会导致估计的峰值摄氧量（V̇O2peak）大幅增加。这可能会降低CR的潜在益处，并可以解释为什么CR在最近的研究中不再能改善患者的生存率。我们的目标是使用金标准最大心肺运动测试（CPET）来确定基于常规运动的CR是否会增加V̇O2peak，并量化可能对接受CR的患者而言不够的运动训练刺激。方法我们研究了常规，每周两次，以运动为基础的CR程序八周（干预组）与有监督运动训练（对照组）的放弃对冠心病患者的影响。主要结果是使用CPET测量的V̇O2peak。我们还在基线，10周和12个月使用双X射线吸收法，颈动脉内膜中层厚度，hs-CRP和N端pro B型利尿钠肽测量了身体成分的变化。我们还计算了口径5年全因死亡率风险评分。结果招募了70例患者（年龄63.1 SD10.0岁； BMI 29.2 SD4.0 kg·m-2；男性86％）（n = 48干预； n = 22对照）。有氧运动训练的平均持续时间为每个训练课23分钟，平均运动训练强度为心率储备的45.9％。基线时V̇O2peak为23·3 ml·kg-1·min-1，各时间点组间V̇O2peak均无变化。干预对任何次要终点均无影响。