275.2 🩺 國考版

275.2.1 高頻考點

275.2.1.1 CR Components

  • Exercise training (aerobic 150 min/wk + resistance 2-3x/wk)
  • Risk factor modification (BP, LDL, HbA1c, smoking, BMI)
  • Mediterranean diet (PREDIMED, CORDIOPREV)
  • Behavioral support (CBT, depression screening)
  • GDMT optimization

275.2.1.2 Indications (Class I)

  • ACS within 12 months
  • Post-CABG / post-PCI
  • Stable CCS
  • HFrEF / HFpEF (Class IIa for HFpEF)
  • Valve surgery / TAVR
  • Transplant / LVAD
  • PAD
  • HCM

275.2.1.3 Key Trials

  • HF-ACTION 2009: CR ↓ HF hosp + death in HFrEF
  • REHAB-HFpEF 2021: improves functional capacity
  • SAINTEX-CAD: HIIT safe + effective in CAD
  • Cochrane 2021 meta-analysis: ↓ mortality, ↓ readmission

275.2.2 易混淆比范

Aspect Aerobic Resistance Flexibility
Goal Cardio fitness, VO₂ Strength, sarcopenia prevention Range of motion
Intensity 60-80% HRmax, RPE 12-14 60-80% 1RM, 10-15 reps Hold 15-30 sec
Frequency 3-5x/wk 2-3x/wk Daily
Duration 30-60 min 1-3 sets per group 5-10 min

275.2.3 Special Topics

275.2.3.1 Exercise Prescription Formula

  • HRmax = 220 - age (or use direct testing if possible)
  • Target HR = HRmax × (60-80%) or HRR × (50-70%) + resting HR
  • VO₂peak from CPET (most precise)
  • Borg Scale = 6-20; target 12-14 (somewhat hard)

275.2.3.2 Risk Stratification for CR

  • Low risk: EF ≥ 50%, no arrhythmia, no symptoms → minimal monitoring
  • Moderate risk: EF 40-49%, mild symptoms → ECG + BP monitoring
  • High risk: EF < 40%, complex arrhythmia, ischemia, recent VT → close monitoring, no high-intensity initially