Efectos del ejercicio isométrico sobre la salud cardiovascular y metabólica en pacientes con enfermedad coronaria: una revisión sistemática
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Ariza Viviescas, Andres Mauricio
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Universidad Santo Tomás
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Introducción: La enfermedad coronaria (EC) es una de las principales causas de morbilidad y mortalidad mundial. El ejercicio isométrico (EI) ha generado interés por su versatilidad y efectos sobre la salud general en diferentes grupos etarios, no obstante, esta modalidad de intervención aún demanda un mayor cuerpo de conocimiento al ser aplicada en pacientes con EC. Objetivo: Evaluar los efectos agudos y crónicos del EI en la salud cardiovascular y metabólica en pacientes con EC mediante una revisión sistemática. Metodología: Esta revisión identificó ensayos clínicos controlados aleatorizados publicados
hasta junio de 2024. Se consultaron las bases de datos Scopus, Web of Science, PubMed y Embase. Dos investigadores independientes realizaron la búsqueda, selección y extracción de los ensayos clínicos. La calidad metodológica se evaluó utilizando la escala PEDro. Resultados: Se identificaron 1.035 registros, de los cuales 875 fueron revisados tras eliminar duplicados. Después de un cribado, se incluyeron 12 estudios completos, de los cuales 8 cumplieron con los criterios de inclusión. El 50% de los estudios mostraron efectos crónicos positivos en la estructura cardíaca, presión arterial y perfusión coronaria, los demás evidenciaron beneficios agudos que produjeron aumento del flujo colateral coronario, reducción de los tiempos y cantidad de fármacos requeridos para la realización de ecocardiografía de estrés. La calidad metodológica de los artículos fue calificada como regular o buena. Conclusión: El EI mostró ser bien tolerado, ofreciendo beneficios crónicos como agudos que mejoran la salud cardiovascular y la eficiencia de pruebas diagnósticas en pacientes con EC.
Abstract
Introduction: Coronary artery disease (CAD) is one of the leading causes of morbidity and mortality worldwide. Isometric exercise (IE) has gained interest due to its versatility and effects on general health across different age groups. However, this intervention modality still requires further research when applied to patients with CAD. Objective: To evaluate the acute and chronic effects of IE on cardiovascular and metabolic health in patients with CAD through a systematic review. Methodology: This review identified randomized controlled clinical trials published up to June 2024 in English, Portuguese, and Spanish. The databases consulted were Scopus, Web of Science, PubMed, and Embase. Two independent researchers conducted the search, selection, and extraction of clinical trials. Methodological quality was assessed using the PEDro scale. Results: A total of 1,035 records were identified, of which 875 were reviewed after duplicates were removed. After screening, 12 full-text studies were included, of which 8 met the inclusion criteria. Half of the studies showed positive chronic effects on cardiac structure, blood pressure, and coronary perfusion, while the others reported acute benefits, including increased coronary collateral flow and reduced time and medication requirements for stress echocardiography. The methodological quality of the articles was rated as fair to good. Conclusion: IE was well tolerated, offering both chronic and acute benefits that improve cardiovascular health and the efficiency of diagnostic tests in patients with CAD
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