Athanasopoulos Leonidas V, Dritsas Athanasios, Doll Helen A, Cokkinos Dennis V
First Cardiology Department, Onassis Cardiac Surgery Center, Athens, Greece.
Eur J Cardiovasc Prev Rehabil. 2010 Aug;17(4):375-9. doi: 10.1097/HJR.0b013e328333e962.
This study was conducted to explain the variance in quality of life (QoL) and activity capacity of patients with congestive heart failure from pathophysiological changes as estimated by laboratory data.
Peak oxygen consumption (peak VO2) and ventilation (VE)/carbon dioxide output (VCO2) slope derived from cardiopulmonary exercise testing, plasma N-terminal prohormone of B-type natriuretic peptide (NT-proBNP), and echocardiographic markers [left atrium (LA), left ventricular ejection fraction (LVEF)] were measured in 62 patients with congestive heart failure, who also completed the Minnesota Living with Heart Failure Questionnaire and the Specific Activity Questionnaire. All regression models were adjusted for age and sex.
On linear regression analysis, peak VO2 with P value less than 0.001, VE/VCO2 slope with P value less than 0.01, LVEF with P value less than 0.001, LA with P=0.001, and logNT-proBNP with P value less than 0.01 were found to be associated with QoL. On stepwise multiple linear regression, peak VO2 and LVEF continued to be predictive, accounting for 40% of the variability in Minnesota Living with Heart Failure Questionnaire score. On linear regression analysis, peak VO2 with P value less than 0.001, VE/VCO2 slope with P value less than 0.001, LVEF with P value less than 0.05, LA with P value less than 0.001, and logNT-proBNP with P value less than 0.001 were found to be associated with activity capacity. On stepwise multiple linear regression, peak VO2 and LA continued to be predictive, accounting for 53% of the variability in Specific Activity Questionnaire score.
Peak VO2 is independently associated both with QoL and activity capacity. In addition to peak VO2, LVEF is independently associated with QoL, and LA with activity capacity.
本研究旨在通过实验室数据估计的病理生理变化来解释充血性心力衰竭患者生活质量(QoL)和活动能力的差异。
对62例充血性心力衰竭患者进行心肺运动试验,测量其峰值耗氧量(peak VO2)和通气(VE)/二氧化碳排出量(VCO2)斜率,检测血浆B型利钠肽前体N末端(NT-proBNP)以及超声心动图指标[左心房(LA)、左心室射血分数(LVEF)],这些患者还完成了明尼苏达心力衰竭生活问卷和特定活动问卷。所有回归模型均根据年龄和性别进行了调整。
线性回归分析发现,peak VO2(P值小于0.001)、VE/VCO2斜率(P值小于0.01)、LVEF(P值小于0.001)、LA(P = 0.001)以及logNT-proBNP(P值小于0.01)与生活质量相关。逐步多元线性回归分析显示,peak VO2和LVEF仍然具有预测性,可解释明尼苏达心力衰竭生活问卷得分变异的40%。线性回归分析表明,peak VO2(P值小于0.001)、VE/VCO2斜率(P值小于0.001)、LVEF(P值小于0.05)、LA(P值小于0.001)以及logNT-proBNP(P值小于0.001)与活动能力相关。逐步多元线性回归分析表明,peak VO2和LA仍然具有预测性,可解释特定活动问卷得分变异的53%。
peak VO2与生活质量和活动能力均独立相关。除peak VO2外,LVEF与生活质量独立相关,LA与活动能力独立相关。