Exercise rehabilitation system and method for PCI postoperative angina pectoris patient

Abstract

The invention discloses an exercise rehabilitation system and method for a PCI postoperative angina pectoris patient, and relates to the technical field of exercise rehabilitation, and the system comprises a perfusion scanning module which is used for carrying out cardiac coronary artery imaging and myocardial perfusion scanning on the patient, and obtaining a myocardial perfusion index of the patient; the danger layering module is used for carrying out danger layering on patients according to myocardial perfusion indexes; the scheme making module is used for making an exercise rehabilitation scheme according to the danger layering result; the data feedback module is used for monitoring the exercise intensity and the heart rate of the patient in the exercise rehabilitation process and adjusting the exercise rehabilitation scheme according to the monitored data. According to the technical scheme, the reason of angina pectoris attack of the patient can be determined, theoretical guidance is provided for further exercise rehabilitation, and the method has high application value.

Description

Technical Field

[0001] The present invention relates to the technical field of sports rehabilitation, and particularly relates to a sports rehabilitation system and method for patients with angina pectoris after PCI. Background Art

[0002] Nowadays, with the continuous update of medical concepts and the in-depth understanding of the pathophysiological mechanism of coronary heart disease, the goals of sports rehabilitation have changed from the traditional prevention of long-term bedridden-related complications after acute myocardial infarction, improvement of symptoms and enhancement of functional levels to slowing down or inhibiting the atherosclerotic process, preventing the occurrence and development of coronary heart disease, reducing the incidence and recurrence rate of cardiovascular events, reducing the mortality rate, prolonging the patient's life, and improving exercise tolerance and quality of life. At present, the rehabilitation after PCI in China is still in the initial stage of development. As of 2021, thousands of hospitals in China have carried out PCI treatment, and the number of PCI treatment cases has exceeded 1 million. The huge population base and the relatively high prevalence rate make the problem of angina pectoris after PCI particularly prominent in China. Therefore, there is an urgent need in China to carry out research on sports rehabilitation after PCI.

[0003] From the perspective of safety, the implementation of sports rehabilitation after PCI is limited by the clinical manifestations of patients, especially those patients who still have angina pectoris attacks after PCI. Therefore, formulating corresponding sports rehabilitation programs based on the microcirculation status of patients is more in line with the clinical needs of such patients. Based on this problem, this application proposes a sports rehabilitation system and method for patients with angina pectoris after PCI. Summary of the Invention

[0004] Technical Objectives In order to solve the above problems, the objective of the present invention is to provide a sports rehabilitation system and method for patients with angina pectoris after PCI. By comparing the traditional rehabilitation program and the sports rehabilitation program formulated based on myocardial perfusion status, evaluate the differences in relieving angina pectoris symptoms, improving cardiopulmonary function and myocardial perfusion indexes, provide a scientific basis for optimizing the sports rehabilitation program after PCI, improve the rehabilitation effect and ensure the safety of patients.

[0005] Technical Solutions In order to achieve the above objective, the present invention provides a sports rehabilitation system and method for patients with angina pectoris after PCI. By performing cardiac coronary angiography and myocardial perfusion scanning on patients, and performing risk stratification on patients according to myocardial perfusion indexes, formulate a sports rehabilitation program based on the risk stratification results and combined with cardiopulmonary exercise test data. During the sports rehabilitation process, monitor the exercise intensity and heart rate of patients, and adjust the sports rehabilitation program according to the monitoring data, so as to clarify the causes of angina pectoris attacks in patients and provide theoretical guidance for sports rehabilitation.

[0006] In a first aspect, the present invention provides a sports rehabilitation system for patients with angina pectoris after PCI, comprising: A perfusion scanning module is used to perform coronary artery imaging and myocardial perfusion scanning on patients and obtain myocardial perfusion indicators of patients; Risk stratification module, used to stratify patients according to myocardial perfusion indicators; Program development module, used to develop exercise rehabilitation programs based on risk stratification results; The data feedback module is used to monitor the patient's exercise intensity and heart rate during the exercise rehabilitation process, and adjust the exercise rehabilitation plan based on the monitoring data.

[0007] Furthermore, the perfusion scanning module analyzes and reconstructs the coronary artery image through maximum density projection, curved surface reconstruction and volume rendering.

[0008] Furthermore, the myocardial perfusion scan includes a resting myocardial perfusion scan and a stress myocardial perfusion scan, the two scanning sequences are substantially the same, and the stress myocardial perfusion scan uses adenosine triphosphate disodium as a stress drug.

[0009] Furthermore, the load drug is continuously administered intravenously at a rate of 170-180ug / kg / min through an infusion pump, and a heart rate increase of 15-20 times is used as the standard for effective load. After this standard is reached, the load myocardial perfusion scan is started, and the drug load is maintained until the end of the scan.

[0010] Furthermore, the myocardial perfusion status was analyzed by myocardial perfusion software.

[0011] Furthermore, the myocardial perfusion index includes density attenuation, perfusion index, enhancement map and transmural perfusion rate, wherein the transmural perfusion rate is used to determine the degree of myocardial perfusion defect.

[0012] Furthermore, the transmural perfusion rate index is calculated segmentally, and the myocardium is divided into endocardium, myometrium and epicardium. The ratio of the endocardial density attenuation of each segment to the epicardial density attenuation of the layer to which it belongs is the transmural perfusion rate.

[0013] Furthermore, the transmural perfusion rate < 0.99 is defined as the presence of myocardial perfusion defect, and the normal range of the transmural perfusion rate is 2.5-0.99, the range of mild defect is 0.99-0.97, the range of moderate defect is 0.97-0.94, and the range of severe defect is 0.94-0.60. This method can accurately reflect the degree of microcirculatory disorder of the patient and avoid misjudgment caused by over-reliance on expert consensus in traditional rehabilitation programs.

[0014] Furthermore, an exercise rehabilitation program is formulated based on the patient's risk stratification and cardiopulmonary exercise test data. High-intensity interval exercise is adopted for patients with low to medium risk, and low to medium-intensity interval exercise is adopted for high-risk patients. The exercise intensity is defined according to the heart rate when the patient reaches the maximum oxygen consumption. The target heart rate for the high-intensity group is 80%-90% HRmax, and the target heart rate for the low to medium-intensity group is 50%-70% HRmax. Through individualized adjustment of exercise intensity, especially for patients who are judged to be at high risk but have good actual perfusion status in the traditional program, higher-intensity rehabilitation training is given, which improves the patient's maximum oxygen uptake and cardiopulmonary function, ensures that the patient achieves an ideal rehabilitation effect on the premise of safety, and reduces the occurrence of adverse events.

[0015] Furthermore, the exercise rehabilitation process also includes warm-up, aerobic training, and relaxation training.

[0016] Furthermore, the data feedback module judges the safety of the exercise rehabilitation program by analyzing the adverse reactions generated by the patient and the physical pain caused by exercise during the exercise rehabilitation process. The dynamic rehabilitation strategy based on data analysis can adjust the treatment plan in a timely manner according to the individual differences and rehabilitation progress of the patient, improving the rehabilitation effect; through the combination of wearable devices and cardiopulmonary exercise test data, it provides technical support for home rehabilitation, enhancing the patient's compliance and rehabilitation effect.

[0017] Furthermore, the data feedback module adjusts the patient's exercise rehabilitation program through a deep reinforcement learning algorithm, and the algorithm formula is:

[0018] where is the value of taking action in state ; is the learning rate; is the immediate reward obtained after taking action in state s; is the discount factor; is the next state after taking action ; is the maximum value of all possible actions in the next state ; is the weight coefficient used to adjust the importance of the change in transmural perfusion rate in the Q-value update; is the change in transmural perfusion rate.

[0019] Furthermore, the system also includes a gated recurrent module for predicting the patient's rehabilitation progress based on the time-dependent data in the patient's real-time physiological data.

[0020] Second aspect, the present invention also provides a method for exercise rehabilitation of patients with angina pectoris after PCI. The method is based on the system described in the first aspect above and includes: Performing cardiac coronary angiography and myocardial perfusion scanning on the patient, and obtaining the patient's myocardial perfusion index; Performing risk stratification on the patient according to the myocardial perfusion index; Formulating an exercise rehabilitation plan according to the risk stratification result; Monitoring the exercise intensity and heart rate of the patient during the exercise rehabilitation process, and adjusting the exercise rehabilitation plan according to the monitoring data.

[0021] Third aspect, the present invention also provides a method for evaluating rehabilitation exercise for patients with angina pectoris after PCI, including: S1. Performing coronary angiography and resting myocardial perfusion scanning, and performing stress myocardial perfusion scanning at an interval of 15-20 minutes after the end of the scanning; S2. After the scanning is completed, transmitting the obtained data to a post-processing workstation. Two experienced physicians, without knowing the patient's clinical data and angiography results, reconstruct and analyze the obtained CCTA images through three post-processing methods: maximum intensity projection, curved planar reformation, and volume rendering, and at the same time analyze the myocardial perfusion status using myocardial perfusion software; S3. Grouping according to the degree of perfusion defect, normal: 2.5-0.99; mild: 0.99-0.97; moderate: 0.97-0.94; severe: 0.94-0.60, which is used as the grouping basis and evaluation index for formulating the exercise rehabilitation plan.

[0022] Preferably, in step S1, the resting myocardial perfusion scanning uses adenosine disodium triphosphate for injection as the stress drug, and a syringe pump is used to continuously administer the drug intravenously at a speed of 170-180 μg / kg / min. Taking an increase in heart rate of 15-20 beats as the standard for effective stress, after reaching this standard, stress myocardial perfusion imaging is started, and the drug stress is maintained until the end of the scanning.

[0023] Preferably, in step S3, mild perfusion defect corresponds to the low-risk group of the consensus risk stratification for rehabilitation after PCI, and its supporting rehabilitation plan is adopted. Moderate perfusion defect group corresponds to the medium-risk group of the consensus risk stratification for rehabilitation after PCI, and its supporting rehabilitation plan is adopted. Severe corresponds to the high-risk group and the corresponding plan.

[0024] Preferably, in step S3, the specific implementation process of formulating the exercise rehabilitation plan includes: formulating the exercise intensity according to the risk stratification and cardiopulmonary exercise test data of the two groups of patients. For patients with low to medium risk, high-intensity interval exercise is adopted, and for high-risk patients, medium to low-intensity interval exercise is used for rehabilitation training. The exercise intensity is defined by the heart rate (HRmax) at the time of reaching the maximum oxygen consumption. The target heart rate for the high-intensity group is 80%-90% HRmax, and the target heart rate for the medium to low-intensity group is 50%-70% HRmax. The exercise process includes warm-up (10 minutes), aerobic training (30-60 minutes), and relaxation training (10 minutes). The exercise frequency is at least 3 times a week. In the first month of the program, in-hospital supervised training is carried out, and thereafter, home training is mainly adopted. The exercise method is freely selected according to the patient's condition. During the exercise process, a wearable device is used to record the heart rate compliance. The research group supervises once a week within 6 months after the implementation of the program, and after 6 months, the patients manage themselves.

[0025] Preferably, in step S3, all patients undergo cardiopulmonary exercise tests before starting exercise rehabilitation, 3 months after implementation, 6 months after implementation, and 12 months after implementation. At the same time, patients in the myocardial perfusion group undergo myocardial perfusion scans before and 12 months after the implementation of the program.

[0026] Preferably, in step S3, the evaluation indicators include: Evaluate the angina attack situation, cardiopulmonary exercise test data, and myocardial perfusion indicators before and after the patient's exercise rehabilitation, including attenuation density (AD), perfusion index (PI), contrast map, and transmyocardial perfusion rate (TPR); Adverse events during the implementation process and exercise-related pain, including: deterioration of angina, acute myocardial infarction, sudden death, syncope, pain in the limbs and trunk, and joint pain.

[0027] Preferably, in step S3, the exercise rehabilitation plan of the patient is adjusted by the deep reinforcement learning algorithm in the foregoing first scheme.

[0028] By adopting the one-stop load myocardial perfusion technology, the coronary artery and myocardial perfusion status can be evaluated simultaneously, and angina attacks caused by coronary artery stenosis can be clearly excluded, ensuring the safety of subsequent cardiac rehabilitation treatment. At the same time, a cardiopulmonary exercise test is combined to evaluate the cardiopulmonary function of the patient and formulate the exercise intensity. Based on the cardiopulmonary exercise test data and the patient's clinical data, the transmural myocardial perfusion index, a semi-quantitative index, is used to grade the microcirculation disorder, and the patient's exercise intensity plan is adjusted accordingly. In the exercise plan, moderate-intensity and high-intensity interval exercises are adopted, and the intensity index is HRmax. An individualized target heart rate range is set. At the same time, to ensure that the enrolled patients can fully guarantee the exercise intensity during the exercise process, a combination of in-hospital centralized training and weekly data review and supervision is used for exercise intensity management. The rehabilitation exercise evaluation method for patients with angina after PCI described in this application can re-classify the high-risk patients on the basis of the traditional rehabilitation exercise evaluation method, individualize their exercise plans, and obtain greater clinical benefits by increasing the exercise intensity while ensuring safety.

[0029] In a fourth aspect, the present invention also provides a computer device, including a processor and a memory. The processor is connected to the memory. The memory is used to store a computer program, and the processor is used to execute the computer program stored in the memory so that the computer device executes at least one step of the aforementioned exercise rehabilitation method for patients with angina after PCI or at least one step of the aforementioned rehabilitation exercise evaluation method for patients with angina after PCI.

[0030] In a fifth aspect, the present invention also provides a computer-readable storage medium. A computer program is stored in the computer-readable storage medium. When the computer program is executed by a processor, it realizes at least one step of the aforementioned exercise rehabilitation method for patients with angina after PCI or at least one step of the aforementioned rehabilitation exercise evaluation method for patients with angina after PCI.

[0031] The present invention proposes an individualized exercise rehabilitation plan that combines myocardial perfusion status and cardiopulmonary exercise test data. By using the one-stop load myocardial perfusion scanning technology to evaluate the coronary artery and myocardial perfusion status of the patient, the cause of the patient's angina attack is clarified, and combined with the cardiopulmonary exercise test data, an individualized exercise intensity and target heart rate range are set; the patient's exercise rehabilitation plan is adjusted by a multi-factor analysis and data-driven method, and the rehabilitation progress of the patient is evaluated by combining the transmural myocardial perfusion index and the cardiopulmonary exercise test data, and the exercise intensity and rehabilitation plan are optimized according to the data feedback. The application scenarios of the system and method are extensive, which can provide a scientific basis for optimizing the exercise rehabilitation plan after PCI, improve the rehabilitation effect and ensure the safety of patients.

[0032] Beneficial effects By implementing the exercise rehabilitation system and method for patients with angina pectoris after PCI provided by the present invention as described above, the following technical effects are achieved: (1) The present invention proposes an individualized exercise rehabilitation plan that combines myocardial perfusion status and cardiopulmonary exercise test data. By using one-stop stress myocardial perfusion scanning technology to evaluate the coronary artery and myocardial perfusion status of patients, the cause of angina pectoris attacks in patients is clarified, and combined with cardiopulmonary exercise test data, individualized exercise intensity and target heart rate ranges are set. It can accurately reflect the degree of microcirculation disorder in patients, avoiding misjudgment caused by over-reliance on expert consensus in traditional rehabilitation plans; through individualized adjustment of exercise intensity, especially for patients who are judged to be at high risk in traditional plans but have good actual perfusion status, higher-intensity rehabilitation training is given, improving the maximum oxygen uptake and cardiopulmonary function of patients, ensuring that patients achieve ideal rehabilitation effects on the premise of safety, and reducing the occurrence of adverse events.

[0033] (2) The exercise rehabilitation plan of patients is adjusted through multi-factor analysis and data-driven methods. The rehabilitation progress of patients is evaluated by combining the transmural myocardial perfusion index and cardiopulmonary exercise test data, and the exercise intensity and rehabilitation plan are optimized according to the data feedback. The dynamic rehabilitation strategy based on data analysis can adjust the treatment plan in a timely manner according to the individual differences and rehabilitation progress of patients, improving the rehabilitation effect; through the combination of wearable devices and cardiopulmonary exercise test data, technical support is provided for home rehabilitation, improving the compliance and rehabilitation effect of patients.

[0034] (3) According to the characteristics of patients' angina pectoris symptoms, myocardial perfusion status, cardiopulmonary function, etc., the exercise rehabilitation plan of patients is dynamically adjusted through a deep reinforcement learning algorithm to maximize the rehabilitation effect and ensure safety. It can significantly improve the rehabilitation effect of patients, reducing the recurrence of angina pectoris or cardiovascular events caused by inappropriate exercise intensity; by continuously improving the exercise rehabilitation plan, improving the rehabilitation efficiency and quality of life of patients; reducing the risk of adverse events occurring during the rehabilitation process of patients and improving the safety of rehabilitation.

[0035] (4) Predict the rehabilitation progress of patients based on the time-dependent data in the real-time physiological data of patients. By effectively processing time series data, a theoretical basis is provided for the adjustment of the rehabilitation plan, improving the rehabilitation effect. By updating the prediction results in real time and dynamically adjusting the prediction according to the latest physiological data and rehabilitation status, the rehabilitation path is optimized, reducing unnecessary risks; it can significantly improve the adaptability and personalization of the exercise rehabilitation plan, reducing the risk of recurrence of angina pectoris caused by inappropriate exercise intensity. BRIEF DESCRIPTION OF THE DRAWINGS

[0036] To make the above-mentioned exercise rehabilitation system and method for patients with angina pectoris after PCI of the present invention more clearly understandable, the accompanying drawings required for the specific implementation manners of the present invention will be briefly introduced below. Obviously, the accompanying drawings in the following description are only some embodiments of the present invention. For those skilled in the art, other accompanying drawings can be obtained based on these drawings without creative efforts.

[0037] Figure 1 It represents a schematic flow chart of an exercise rehabilitation method for patients with angina pectoris after PCI; Figure 2 It represents a schematic technical route diagram; Figure 3 It represents a schematic rehabilitation process diagram for high-risk angina pectoris patients after PCI. Specific implementation manners

[0038] Example 1: An exercise rehabilitation system and method for patients with angina pectoris after PCI are provided. The exercise rehabilitation system for patients with angina pectoris after PCI includes: a perfusion scanning module, a risk stratification module, a plan formulation module, and a data feedback module. The flow of the exercise rehabilitation method for patients with angina pectoris after PCI is as Figure 1 shown. Specifically, the exercise rehabilitation system and method for patients with angina pectoris after PCI in the following steps, and the technical route is as Figure 2 shown.

[0039] The perfusion scanning module is used to perform cardiac coronary artery imaging and myocardial perfusion scanning on the patient, and obtain the myocardial perfusion index of the patient.

[0040] The perfusion scanning module analyzes and reconstructs the cardiac coronary artery image by means of maximum intensity projection, curved surface reconstruction, and volume rendering.

[0041] The myocardial perfusion scanning includes resting myocardial perfusion scanning and stress myocardial perfusion scanning. The two scanning sequences are basically the same. The stress myocardial perfusion scanning uses adenosine disodium triphosphate as the stress drug.

[0042] The stress myocardial perfusion scan is performed 15 - 20 minutes after the resting myocardial perfusion scan. The scan is carried out using a 320 - slice dynamic volume CT, and the scan mode is the prospective electrocardiogram - triggered technique target area. The double - positioning image scan range is from the tracheal bifurcation to the lower part of the diaphragmatic surface of the heart on both the left and right sides. First, a plain scan of the coronary artery calcium score is performed. The scan parameters include a tube voltage of 100 KV, a tube current of 300 - 450 mAs / rot, a slice thickness of 0.5 mm, an interval of 0.5 mm, and a field of view of 180 - 220 mm. Then, the scan mode is switched to electrocardiogram - gated dynamic volume, and a continuous acquisition scan with a conventional dose is performed. A non - ionic contrast agent, iopromide, with a concentration of 370 mg I / mL and a volume of 50 - 60 ml is injected through a double - barrel high - pressure syringe into the right antecubital vein at a flow rate. After the injection is completed, saline is injected at the same flow rate to flush the catheter. The enhanced range is set to be the same as that in the plain scan. The scan parameters include a tube voltage of 120 KV and a tube current of 350 - 450 mAs / rot. The proximal part of the thoracic aorta is selected as the region of interest for value monitoring through an intelligent trigger scan system. When the density in the region of interest reaches the preset value, the coronary artery and resting myocardial perfusion scans are started, and the electrocardiogram is recorded synchronously during the scan process. Scans of the heart are performed at intervals starting from the start time of the myocardial perfusion scan and delayed resting scans are also carried out using the prospective electrocardiogram - triggered technique interval. The scan parameters include a tube voltage of 100 KV and a tube current of 300 - 400 mAs / rot.

[0043] The stress drug is continuously administered intravenously through an infusion pump at a speed of 170 - 180 μg / kg / min. An increase in heart rate by 15 - 20 beats is used as the standard for effective stress. After reaching this standard, the stress myocardial perfusion scan is started, and the drug stress is maintained until the scan ends.

[0044] The myocardial perfusion status is analyzed through myocardial perfusion software.

[0045] The myocardial perfusion indexes include density attenuation, perfusion index, enhancement map, and transmural perfusion rate. Among them, the transmural perfusion rate is used to judge the degree of myocardial perfusion defect.

[0046] The transmural perfusion rate index is calculated by segment. The myocardium is divided into endocardium, myocardium, and epicardium. The ratio of the density attenuation of the endocardium of each segment to the density attenuation of the epicardium of its corresponding layer is the transmural perfusion rate.

[0047] A transmural perfusion rate < 0.99 is defined as the presence of a myocardial perfusion defect. The normal range of the transmural perfusion rate is 2.5 - 0.99, the mild defect range is 0.99 - 0.97, the moderate defect range is 0.97 - 0.94, and the severe defect range is 0.94 - 0.60.

[0048] The risk stratification module is used to perform risk stratification on patients according to myocardial perfusion indexes.

[0049] Mild perfusion defects correspond to the low-risk group in the risk stratification for PCI postoperative rehabilitation, moderate perfusion defects correspond to the medium-risk group, and severe perfusion defects correspond to the high-risk group. The rehabilitation process for high-risk angina patients after PCI is as Figure 3 shown.

[0050] The program formulation module is used to formulate an exercise rehabilitation program according to the risk stratification results.

[0051] An exercise rehabilitation program is formulated based on the patient's risk stratification and cardiopulmonary exercise test data. High-intensity interval exercise is used for patients with medium and low risks, and medium and low-intensity interval exercise is used for high-risk patients. The exercise intensity is defined according to the heart rate when the patient reaches the maximum oxygen consumption. The target heart rate for the high-intensity group is 80%-90% HRmax, and the target heart rate for the medium and low-intensity group is 50%-70% HRmax.

[0052] The exercise rehabilitation process also includes warm-up, aerobic training, and relaxation training. The exercise frequency is at least 3 times a week. The first month of the program is supervised training in the hospital, and then home training is mainly carried out. The exercise method is determined according to the patient's condition. The heart rate compliance is recorded through wearable devices during the exercise process. The research group supervises once a week within 6 months after the program implementation, and the patients manage themselves after 6 months. All patients need to undergo cardiopulmonary exercise tests before starting exercise rehabilitation, 3 months, 6 months, and 12 months after implementation. At the same time, patients with load myocardial perfusion need to undergo myocardial perfusion scans before and 12 months after the program implementation.

[0053] A total of 121 patients were included in this example, including 74 patients in the traditional rehabilitation group and 47 patients in the load myocardial perfusion rehabilitation group. Based on this, a comparative study on the exercise rehabilitation effect was carried out.

[0054] The baseline data of angina patients are shown in Table 1.

[0055] Table 1. Baseline data of angina patients

[0056] The data in the table are expressed as percentage n (%), mean ± standard deviation. P < 0.05 indicates that there is a statistically significant difference between the two. is the maximum oxygen uptake, HR is the heart rate when reaching the maximum oxygen uptake, is the oxygen pulse, and MET is the metabolic equivalent.

[0057] The baseline data of the traditional rehabilitation group are shown in Table 2.

[0058] Table 2. Baseline data of the traditional rehabilitation group

[0059] The baseline data of the myocardial perfusion group are shown in Table 3.

[0060] Table 3, Baseline Data of the Myocardial Perfusion Group

[0061] Whether in the traditional rehabilitation group or the myocardial perfusion group, there were no significant statistical differences in cardiopulmonary exercise parameters between the high-risk group and the medium- and low-risk groups.

[0062] The symptom remission conditions of the two groups of angina patients are shown in Table 4.

[0063] Table 4, Symptom Remission Conditions of the Two Groups of Angina Patients

[0064] The remission rate of angina in the traditional rehabilitation group was 82.43%, and the remission rate of angina in the myocardial perfusion group was 78.72%. There was no significant statistical difference between the two.

[0065] Traditional Rehabilitation Group after 6 Months of Exercise Rehabilitation The changes are shown in Table 5.

[0066] Table 5, Traditional Rehabilitation Group after 6 Months of Exercise Rehabilitation Change Conditions

[0067] In the traditional rehabilitation group, there was no significant statistical difference in the cardiopulmonary exercise test between the two groups at 6 months.

[0068] Myocardial Perfusion Group after 6 Months of Exercise Rehabilitation The changes are shown in Table 6.

[0069] Table 6, Myocardial Perfusion Group after 6 Months of Exercise Rehabilitation Change Conditions

[0070] In the myocardial perfusion group, there was no significant statistical difference in the cardiopulmonary exercise test between the two groups at 6 months.

[0071] As mentioned above, there was no significant statistical difference in the cardiopulmonary exercise test between the two groups at 6 months. The medium- and low-risk groups in the myocardial perfusion group could be defined as high-risk groups according to the judgment criteria of the traditional rehabilitation group. Comparing the medium- and low-risk groups in the myocardial perfusion group with the high-risk groups in the traditional rehabilitation group, it can be seen that after evaluation with myocardial perfusion and giving patients higher-intensity training, the improvement degree of the maximum oxygen uptake is more significant than that of the traditional rehabilitation program.

[0072] The comparison results between the medium- and low-risk groups in the myocardial perfusion group and the high-risk groups in the traditional rehabilitation group are shown in Table 7.

[0073] Table 7. Comparison results between the low- and medium-risk groups in the myocardial perfusion group and the high-risk group in the traditional rehabilitation group

[0074] According to the research results, as the duration of exercise rehabilitation prolongs, the maximum oxygen uptake of patients in each group shows an upward trend. Regardless of the adopted scheme, exercise rehabilitation has a positive effect on improving the oxygen uptake capacity of the body and cardiopulmonary function. By comparing the low- and medium-risk groups in the myocardial perfusion group and the high-risk group in the traditional rehabilitation group, it can be seen that on the premise of ensuring the safety of patients, increasing the exercise intensity of patients is an effective means to improve the condition of angina pectoris in patients.

[0075] The data feedback module is used to monitor the exercise intensity and heart rate of patients during exercise rehabilitation and adjust the exercise rehabilitation scheme according to the monitored data.

[0076] The data feedback module judges the safety of the exercise rehabilitation scheme by analyzing the adverse reactions generated by patients during exercise rehabilitation and the physical pain caused by exercise.

[0077] The data involved in the system is analyzed by SPSS statistical software. Among them, continuous variables are expressed by mean ± standard deviation or median and interquartile range, and categorical variables are expressed by percentage or frequency. For continuous variables, a normal distribution test is performed. For continuous variables that conform to the normal distribution, an independent sample t-test is used for pairwise comparison. For continuous variables that do not conform to the normal distribution, the Mann-Whitney U rank sum test is used; for the statistics of categorical variables, the χ2 test or Fisher's exact probability method is used for comparison. The correlation between the improvement degree of transmural perfusion rate and exercise intensity is analyzed by Spearman correlation coefficient. All statistical analyses adopt two-sided tests, and P < 0.05 indicates a difference with statistical significance.

[0078] Example 2: A rehabilitation exercise evaluation method for patients with angina pectoris after PCI is provided, including: S1. Perform coronary angiography and resting myocardial perfusion scanning, and perform stress myocardial perfusion scanning 15 - 20 minutes after the scanning ends; S2. After the scanning is completed, transfer the obtained data to the post-processing workstation. Two experienced physicians, without knowing the clinical data and angiography results of the patients, reconstruct and analyze the obtained CCTA images through three post-processing methods: maximum intensity projection, curved planar reformation, and volume rendering, and at the same time analyze the myocardial perfusion status by applying myocardial perfusion software; S3. Group according to the degree of perfusion defect. Normal: 2.5 - 0.99; Mild: 0.99 - 0.97; Moderate: 0.97 - 0.94; Severe: 0.94 - 0.60. This is used as the basis for grouping and evaluation index for formulating the exercise rehabilitation plan.

[0079] In step S1, the resting myocardial perfusion scan uses adenosine disodium triphosphate for injection as the loading drug, and a syringe pump is used to continuously administer the drug intravenously at a speed of 170 - 180 μg / kg / min. The standard for effective loading is an increase in heart rate by 15 - 20 beats. After reaching this standard, the stress myocardial perfusion imaging is initiated, and the drug load is maintained until the end of the scan.

[0080] In step S3, mild perfusion defect corresponds to the low-risk group of the consensus PCI postoperative rehabilitation risk stratification, and its supporting rehabilitation plan is adopted. The moderate perfusion defect group corresponds to the medium-risk group of the consensus PCI postoperative rehabilitation risk stratification, and its supporting rehabilitation plan is adopted. Severe corresponds to the high-risk group and the corresponding plan.

[0081] In step S3, the specific implementation process of formulating the exercise rehabilitation plan includes: formulating the exercise intensity according to the risk stratification and cardiopulmonary exercise test data of the two groups of patients. Patients with medium and low risks adopt high-intensity interval exercise, and patients with high risks adopt medium and low-intensity interval exercise for rehabilitation training. The exercise intensity is defined by the heart rate (HRmax) at the time of reaching the maximum oxygen consumption. The target heart rate for the high-intensity group is 80% - 90% HRmax, and the target heart rate for the medium and low-intensity group is 50% - 70% Hrmax. The exercise process includes warm-up, aerobic training, and relaxation training. The exercise frequency is at least 3 times a week. The first month of the plan is supervised training in the hospital, and then home training is mainly carried out. The exercise method is freely selected according to the patient's situation. The heart rate compliance is recorded using wearable devices during the exercise process. The research group supervises once a week within 6 months of the plan implementation, and after 6 months, the patients manage themselves.

[0082] In step S3, all patients perform cardiopulmonary exercise tests before starting exercise rehabilitation, 3 months after implementation, 6 months after implementation, and 12 months after implementation. At the same time, patients in the stress myocardial perfusion group perform myocardial perfusion scans before the plan implementation and 12 months after implementation.

[0083] In step S3, the evaluation indicators include: Evaluate the angina pectoris attack situation, cardiopulmonary exercise test data, and myocardial perfusion indicators before and after the patient's exercise rehabilitation, including density attenuation, perfusion index, enhancement map, and transmural perfusion rate; Adverse events during the implementation process and pain related to exercise, including: deterioration of angina pectoris, acute myocardial infarction, sudden death, syncope, pain in the limbs and trunk, joint pain.

[0084] Example 3: Based on the foregoing embodiments, the data feedback module dynamically adjusts the patient's exercise rehabilitation plan according to the characteristics of the patient's angina symptoms, myocardial perfusion status, cardiopulmonary function, etc. through a deep reinforcement learning algorithm to maximize the rehabilitation effect and ensure safety.

[0085] The perfusion scanning module collects the patient's myocardial perfusion scan results, cardiopulmonary exercise test data, and monitoring data during the exercise rehabilitation process, and cleans the data to remove noise and outliers, and standardizes or normalizes the data to construct the patient's state feature vector.

[0086] The deep reinforcement learning algorithm uses the Q-learning algorithm to determine the expected return of taking a certain action in a given state by learning the Q function. The formula is:

[0087] In the formula, is the value of taking action in state ; is the learning rate, which determines the speed at which new messages overwrite old messages; is the immediate reward obtained after taking an action in state s; is the discount factor, which determines the current value of future rewards; is the next state after taking action ; is the maximum value of all possible actions in the next state ; is the weight coefficient, which is used to adjust the importance of the change in the transmural perfusion rate in the Q-value update; is the change in the transmural perfusion rate.

[0088] The architecture design of the neural network includes: Input layer: Receives the patient's current state features, such as heart rate, maximum oxygen uptake, transmural perfusion rate, etc.; Hidden layer: Extracts features through a convolutional neural network; Output layer: Outputs the probability distribution or Q-value of the action for selecting the optimal rehabilitation action.

[0089] Train the model offline based on the patient's historical monitoring data and dynamically adjust the rehabilitation strategy according to the patient's real-time feedback.

[0090] Evaluate the performance of the model in different patient groups through the cross-validation method.

[0091] By dynamically adjusting the exercise rehabilitation plan according to the patient's real-time physiological data and rehabilitation progress, the rehabilitation effect of the patient can be significantly improved. The algorithm is relatively simple and has low complexity. Verification shows that when obtaining an average error similar to that of the above-mentioned embodiment, only about 20% of the data it collects is required to determine the optimal rehabilitation strategy, indicating that the data feedback module helps to more quickly formulate a reasonable exercise rehabilitation plan on the basis of ensuring safety, effectively improve the patient's rehabilitation effect, shorten the exercise rehabilitation course, and improve the reliability of the system.

[0092] Embodiment 4: On the basis of the foregoing embodiment, the system is additionally provided with a gated recurrent module for predicting the patient's rehabilitation progress according to the time-dependent data in the patient's real-time physiological data.

[0093] The myocardial perfusion scan results, cardiopulmonary exercise test data, and monitoring data during the exercise rehabilitation process of the patient are collected through the perfusion scan module and the data feedback module, and the data is cleaned to remove noise and outliers, and the data is normalized to the same range to construct a time series sample.

[0094] The gated recurrent module controls the flow of information through the update gate and the reset gate, thereby effectively processing time series data. The update formula of the gated recurrent model is:

[0095]

[0096]

[0097]

[0098] In the formula, is the update gate, which determines how much past information is retained to the current state; is the reset gate, which determines how much past information is used to calculate the current candidate state; is the sigmoid function, which is used to map the input to between 0 and 1; is the weight matrix; is the hidden state of the previous time step; is the input of the current time step; is the candidate hidden state of the current time step; is the hidden state of the current time step; is the weight coefficient; is the difference in the transmural perfusion rate between the current time step and the previous time step.

[0099] The architecture design of the gated recurrent unit includes: Input layer: Receives preprocessed time series data, such as heart rate, exercise intensity, maximal oxygen uptake, etc.; Gated recurrent unit layer: Processes time series data using multiple gated recurrent units and captures time dependencies; Output layer: Outputs predicted rehabilitation metrics, such as changes in maximal oxygen uptake, probability of relief of angina symptoms, etc.

[0100] The mean squared error loss function is used when predicting changes in maximal oxygen uptake, and the cross-entropy loss function is used when predicting the relief of angina symptoms.

[0101] Divide the collected time series data into a training set and a validation set, and use historical data to train the gated recurrent model to learn the dynamic changes during the patient's rehabilitation process.

[0102] Train the gated recurrent model using the gradient descent method. During the training process, monitor the loss of the validation set to prevent overfitting, and use the early stopping mechanism to optimize the model performance.

[0103] Evaluate the performance of the model in different patient groups through cross-validation methods.

[0104] For example, assume there is a set of time series data of heart rate, exercise intensity, and transmural perfusion rate for a group of patients; Assume further that there is the following simplified time series data: Time step 1, heart rate 70, exercise intensity 0.6, change in transmural perfusion rate 0.02, current maximal oxygen uptake 25; Time step 2, heart rate 72, exercise intensity 0.7, change in transmural perfusion rate 0.03, current maximal oxygen uptake 26; Time step 3, heart rate 75, exercise intensity 0.8, change in transmural perfusion rate 0.01, current maximal oxygen uptake 27; Time step 4, heart rate 78, exercise intensity 0.9, change in transmural perfusion rate 0.02, current maximal oxygen uptake 28; Time step 5, heart rate 80, exercise intensity 1.0, change in transmural perfusion rate 0.03, current maximal oxygen uptake 29.

[0105] Assume weight coefficients , and other weight matrices are simplified to be randomly initialized, with the initial hidden state ; On the first day, the input is ;

[0106]

[0107]

[0108]

[0109] Similar calculations and until the hidden state on the 5th day ; Assume the final hidden state is used to predict the maximal oxygen uptake on the 6th day, and assume the output layer is a linear layer, , and :

[0110] Assume the actual maximal oxygen uptake on the 6th day is 30, and the model prediction result is 30.8, with a prediction error of 0.8.

[0111] The effect of the gated recurrent module is shown in Table 8.

[0112] Table 8. Summary of the gated recurrent module

[0113] According to the experimental table, the gated recurrent module can accurately predict the changes in maximal oxygen uptake during the patient's recovery process, with a small prediction error, indicating that the module can effectively capture the dynamic changes in time series data and is highly sensitive to the myocardial perfusion state.

[0114] Those skilled in the art should understand that the embodiments of the present invention can be provided as a method, a system, or a computer program product. Therefore, the present invention can take the form of a complete hardware embodiment, a complete software embodiment, or an embodiment combining software and hardware aspects. Moreover, the present invention can take the form of a computer program product implemented on one or more computer-usable non-transitory storage media containing computer-usable program code.

[0115] The present invention can provide computer program instructions to the processor of a general-purpose computer, a special-purpose computer, an embedded processor, or other programmable data processing devices to generate a machine, such that the instructions executed by the processor of the computer or other programmable data processing devices generate a device for implementing the system.

[0116] These computer program instructions can also be stored in a computer-readable memory that can direct a computer or other programmable data processing device to work in a specific manner, such that the instructions stored in the computer-readable memory generate a manufactured article including an instruction device that implements the functions of the system.

[0117] These computer program instructions can also be loaded onto a computer or other programmable data processing apparatus, so as to cause a series of operational steps to be performed on the computer or other programmable apparatus to produce a computer-implemented process, thereby providing steps for implementing the functions of the system on the computer or other programmable apparatus.

Claims

1. A sports rehabilitation system for patients with angina pectoris after PCI, characterized in that: include: A perfusion scanning module is used to perform coronary artery imaging and myocardial perfusion scanning on patients and obtain myocardial perfusion indicators of patients; Risk stratification module, used to stratify patients according to myocardial perfusion indicators; Program development module, used to develop exercise rehabilitation programs based on risk stratification results; The data feedback module is used to monitor the patient's exercise intensity and heart rate during the exercise rehabilitation process, and adjust the exercise rehabilitation plan based on the monitoring data.

2. The system according to claim 1, characterized in that: The perfusion scanning module analyzes and reconstructs the coronary artery image through maximum density projection, curved surface reconstruction and volume rendering.

3. The system according to claim 1, characterized in that: The myocardial perfusion scan includes a resting myocardial perfusion scan and a stress myocardial perfusion scan, and the stress myocardial perfusion scan uses adenosine triphosphate disodium as a stress drug.

4. The system according to claim 3, characterized in that: The myocardial perfusion indexes include density attenuation, perfusion index, enhancement map and transmural perfusion rate, wherein the transmural perfusion rate is used to judge the degree of myocardial perfusion defect.

5. The system according to claim 1, characterized in that: The data feedback module determines the safety of the exercise rehabilitation program by analyzing the adverse reactions and exercise-induced body pain produced by the patient during the exercise rehabilitation process.

6. The system according to claim 1, characterized in that: The data feedback module adjusts the patient's exercise rehabilitation program through a deep reinforcement learning algorithm. The algorithm formula is: In the formula, For the status Take action of value; is the learning rate; To take action in state s Immediate rewards after is the discount factor; To take action The next state after For the next state The maximum of all possible moves value; is the weight coefficient, which is used to adjust the importance of the change in transmural perfusion rate in the Q value update; is the change in transmural perfusion rate.

7. The system according to claim 1, characterized in that: The system also includes a gated loop module for predicting the patient's recovery progress based on time-dependent data in the patient's real-time physiological data.

8. A method of exercise rehabilitation for patients with angina pectoris after PCI, characterized in that: The method is implemented based on the system according to any one of claims 1 to 7: The method comprises: Perform coronary artery imaging and myocardial perfusion scanning on patients and obtain myocardial perfusion indicators of patients; Patients were risk-stratified based on myocardial perfusion indices; Formulate exercise rehabilitation plan based on risk stratification results; Monitor the patient's exercise intensity and heart rate during exercise rehabilitation, and adjust the exercise rehabilitation plan based on the monitoring data.

9. A method for evaluating rehabilitation exercise for patients with angina pectoris after PCI, characterized in that include: S1: Perform coronary artery imaging and resting myocardial perfusion scan, and perform stress myocardial perfusion scan 15-20 minutes after the scan. S2. After the scan is completed, the data is transmitted to the post-processing workstation. Two experienced physicians, without knowing the patient's clinical information and angiography results, reconstruct and analyze the coronary artery images through three post-processing methods: maximum density projection, curved surface reconstruction, and volume rendering. At the same time, myocardial perfusion software is used to analyze the myocardial perfusion status. S3, grouped according to the degree of perfusion defect, normal: 2.5-0.99; Mild: 0.99-0.97; Moderate: 0.97-0.94; Severe: 0.94-0.60, which is used as the basis for grouping and evaluation indicators for formulating exercise rehabilitation plans.

10. A computer device comprising a processor and a memory, wherein the processor is connected to the memory, and the memory is used to store a computer program, wherein: The processor is used to execute the computer program stored in the memory so that the computer device performs at least one step of the aforementioned exercise rehabilitation method for patients with angina pectoris after PCI or at least one step of the aforementioned rehabilitation exercise evaluation method for patients with angina pectoris after PCI.

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