Warburton D E, Haykowsky M J, Quinney H A, Humen D P, Teo K K
Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Canada.
Sports Med. 1999 Jan;27(1):23-41. doi: 10.2165/00007256-199927010-00003.
The assessment of cardiac function, particularly cardiac output (Q) during heavy exercise is essential for the evaluation of cardiovascular factors that might limit oxygen transport. A series of invasive and noninvasive techniques has been developed for the assessment and monitoring of Q during resting and submaximal exercise conditions. However, very few techniques have been found to give accurate and reliable determinations of Q during vigorous to maximum exercise. For exercise physiologists and sport cardiologists, maximal exercise data are of primary importance. The 'gold standard' measures of cardiac function are considered to be the direct Fick and dye-dilution methods. These have been widely shown to give accurate and reliable determinations of Q during resting and submaximal exercise conditions; however, their use during maximal exercise conditions is debatable due to the inherent risks involved with each and their increasing inaccuracy during the later stages of vigorous exercise. Thermodilution has also been considered to be a relatively good method for the determination of Q during rest and exercise conditions, but recent authors have questioned its use due to the nature of the measure and its inaccuracy during strenuous exercise. Various noninvasive measures of cardiac function have been developed to overcome the problems associated with the 'gold standard' measures. The first part of this article discusses conventional techniques used in exercise physiology settings. The majority of these provide accurate and reliable determinations of Q during rest and submaximal exercise. However, very few techniques are suitable for maximal exercise conditions. Perhaps only the foreign gas rebreathe using acetylene (C2H2) meets all the criteria of being noninvasive, simple to use, reliable over repeated measurements, accurate and useful during maximal exercise.
评估心脏功能，尤其是剧烈运动期间的心输出量（Q），对于评估可能限制氧气输送的心血管因素至关重要。已经开发出一系列侵入性和非侵入性技术，用于在静息和次最大运动条件下评估和监测心输出量。然而，很少有技术能在剧烈到最大运动期间准确可靠地测定心输出量。对于运动生理学家和运动心脏病学家来说，最大运动数据至关重要。心脏功能的“金标准”测量方法被认为是直接菲克法和染料稀释法。这些方法已被广泛证明在静息和次最大运动条件下能准确可靠地测定心输出量；然而，由于每种方法都存在固有风险以及在剧烈运动后期其准确性不断下降，它们在最大运动条件下的应用存在争议。热稀释法也被认为是在静息和运动条件下测定心输出量的一种相对较好的方法，但最近的作者因其测量性质及其在剧烈运动期间的不准确性而对其应用提出了质疑。已经开发出各种心脏功能的非侵入性测量方法，以克服与“金标准”测量方法相关的问题。本文的第一部分讨论了运动生理学环境中使用的传统技术。其中大多数在静息和次最大运动期间能准确可靠地测定心输出量。然而，很少有技术适用于最大运动条件。也许只有使用乙炔（C2H2）的外源性气体再呼吸法符合所有标准，即非侵入性、使用简单、多次测量可靠、在最大运动期间准确且有用。
