先天性心脏病成人患者摄氧效率斜率的准确性

Accuracy of oxygen uptake efficiency slope in adults with congenital heart disease.

作者信息

Giardini Alessandro, Specchia Salvatore, Gargiulo Gaetano, Sangiorgi Diego, Picchio Fernando M

机构信息

Pediatric Cardiology and Adult Congenital Unit, University of Bologna, Bologna, Italy.

出版信息

Int J Cardiol. 2009 Mar 20;133(1):74-9. doi: 10.1016/j.ijcard.2007.11.092. Epub 2008 Feb 1.

DOI:10.1016/j.ijcard.2007.11.092

PMID:18242739

Abstract

BACKGROUND

Given its linearity throughout exercise, oxygen uptake efficiency slope (OUES) obtained with a sub-maximal exercise is considered a reliable predictor of exercise capacity. We sought to assess the linearity of OUES across different exercise stages in adults with various forms of congenital heart disease.

METHODS

Using cardiopulmonary exercise testing, we studied 23 patients after a Fontan operation, and 30 patients after atrial repair for complete transposition of the great arteries, at a mean age of 24+/-10 years. Thirty-five healthy volunteers were used as controls. OUES was calculated from 100% (OUES), the first 50% (OUES(50)), and the last 50% (OUES(50-100)) of the entire exercise duration.

RESULTS

Peak oxygen uptake and OUES were reduced in Fontan patients when compared to atrial repair or control subjects (p<0.05). However, whereas in atrial repair and in control subjects OUES(50), OUES(50-100), and OUES appeared to be similar (p>0.05), in Fontan patients OUES(50) appeared to be lower than OUES(50-100) (1.38+/-0.46 vs. 1.78+/-0.51, p=0.01) and OUES (1.38+/-0.46 vs. 1.72+/-0.56, p=0.032). The difference between OUES(50) and OUES(50-100) appeared particularly large in cyanotic Fontan patients (1.40+/-0.42 vs. 1.93+/-0.68, p=0.001), whereas no difference was observed in Fontan patients with normal saturation (1.33+/-0.59 vs. 1.37+/-0.67, p=0.922).

CONCLUSIONS

In cyanotic Fontan patients, OUES(50) differs substantially from OUES(50-100) and OUES. Therefore, OUES(50) is unable to predict maximal exercise capacity in this population.

摘要

背景

鉴于其在整个运动过程中的线性关系，次极量运动时获得的摄氧效率斜率（OUES）被认为是运动能力的可靠预测指标。我们试图评估不同形式先天性心脏病成人在不同运动阶段OUES的线性关系。

方法

采用心肺运动试验，我们研究了23例接受Fontan手术的患者和30例接受大动脉完全转位心房修复术的患者，平均年龄为24±10岁。35名健康志愿者作为对照。OUES根据整个运动持续时间的100%（OUES）、前50%（OUES(50)）和后50%（OUES(50 - 100)）计算得出。

结果

与心房修复术患者或对照受试者相比，Fontan手术患者的峰值摄氧量和OUES降低（p<0.05）。然而，在心房修复术患者和对照受试者中，OUES(50)、OUES(50 - 100)和OUES似乎相似（p>0.05），而在Fontan手术患者中，OUES(50)似乎低于OUES(50 - 100)（1.38±0.46对1.78±0.51，p = 0.01）和OUES（1.38±0.46对1.72±0.56，p = 0.032）。在青紫型Fontan手术患者中，OUES(50)与OUES(50 - 100)之间的差异尤为显著（1.40±0.42对1.93±0.68，p = 0.001），而在血氧饱和度正常的Fontan手术患者中未观察到差异（1.33±0.59对1.37±0.67，p = 0.922）。