氧摄取效率斜率与心力衰竭患者的脑利钠肽相关。

Oxygen uptake efficiency slope correlates with brain natriuretic peptide in patients with heart failure.

机构信息

1st Department of Cardiology, University School of Medical Sciences, Długa 1/2, Poznań, Poland.

出版信息

Cardiol J. 2010;17(4):362-6.

PMID:20690091

Abstract

BACKGROUND

Cardiopulmonary exercise testing is a well-established tool for clinical and prognostic assessment of patients with chronic heart failure (CHF). Recently, a new parameter of this examination--oxygen uptake efficiency slope (OUES)--has been described and proposed as a new prognostic factor in patients with CHF. Brain natriuretic peptide (BNP) is an established prognostic factor in CHF. The purpose of the study was to assess OUES in patients with CHF in relation to other cardiopulmonary parameters and BNP levels.

METHODS

The study group consisted of 42 patients with CHF and left ventricular ejection fraction (LVEF) < 45% (mean age 50.2 +/- 9.3 years, mean ejection fraction 26.1 +/- 8.1% and NYHA functional class - 2.5 +/- 0.8) and eight healthy controls (age 43.6 +/- 14.7 years). Coronary artery disease was diagnosed in 16 patients (38%). All underwent maximal cardiopulmonary exercise treadmill test. BNP level was measured using Abbott AxSYM Immunoassay system.

RESULTS

There were significant (p < 0.001) differences between the patients and controls in BNP levels (350 +/- 520 vs 14 +/- 19 pg/mL), OUES (1.7 +/- 0.4 vs 2.7 +/- 0.5), peak VO(2) (17.1 +/- +/- 5.1 vs 36.9 +/- 4.9 mL/kg/min), O(2) pulse (10.9 +/- 3.3 vs 15.9 +/- 2.7) and VE/VCO(2) slope (35.7 +/- 7.8 vs 25.7 +/- 2.7). In patients, OUES was significantly (p < 0.001) correlated with LVEF (r = 0.54), BNP levels (r = -0.49), peak VO(2) (r = 0.80), VO(2) AT (r = 0.65) and VE/VCO(2) slope (r = -0.59). BNP was independently related to OUES in multivariate regression analysis.

CONCLUSIONS

Oxygen uptake efficiency slope is significantly reduced in patients with CHF and correlates with peak VO(2) and other parameters of cardiopulmonary exercise treadmill test. It is not related to age. BNP is an independent marker of OUES in patients with CHF.

摘要

背景

心肺运动测试是一种用于评估慢性心力衰竭（CHF）患者的临床和预后的成熟工具。最近，该检查的一个新参数——摄氧量效率斜率（OUES）——已被描述并被提议作为 CHF 患者的新预后因素。脑利钠肽（BNP）是 CHF 的既定预后因素。本研究的目的是评估 CHF 患者的 OUES 与其他心肺参数和 BNP 水平的关系。

方法

研究组包括 42 名 CHF 患者和左心室射血分数（LVEF）<45%（平均年龄 50.2±9.3 岁，平均射血分数 26.1±8.1%，纽约心脏协会功能分级-2.5±0.8）和 8 名健康对照者（年龄 43.6±14.7 岁）。16 名患者（38%）被诊断为冠状动脉疾病。所有患者均接受最大心肺运动跑步机测试。使用 Abbott AxSYM 免疫分析系统测量 BNP 水平。

结果

患者与对照组在 BNP 水平（350±520 与 14±19 pg/mL）、OUES（1.7±0.4 与 2.7±0.5）、峰值 VO₂（17.1±5.1 与 36.9±4.9 mL/kg/min）、O₂脉冲（10.9±3.3 与 15.9±2.7）和 VE/VCO₂斜率（35.7±7.8 与 25.7±2.7）方面存在显著差异（p<0.001）。在患者中，OUES 与 LVEF（r=0.54）、BNP 水平（r=-0.49）、峰值 VO₂（r=0.80）、VO₂AT（r=0.65）和 VE/VCO₂斜率（r=-0.59）呈显著相关性（p<0.001）。多元回归分析显示，BNP 与 OUES 独立相关。