Arena Ross, Myers Jonathan, Guazzi Marco
Physical Therapy Program, Department of Orthopaedics and Rehabilitation, School of Medicine, University of New Mexico, Albuquerque, NM 87131-0001, USA.
Congest Heart Fail. 2011 May-Jun;17(3):115-9. doi: 10.1111/j.1751-7133.2011.00216.x. Epub 2011 Apr 13.
Despite advances in the treatment of heart failure (HF), which have resulted in improved survival, overall prognosis continues to be poor. Given the high short-term mortality rate, it remains important to utilize assessment techniques with established prognostic value in this patient population. Ideally, a given assessment should also be able to accurately reflect disease severity, a heterogeneous phenomenon in patients with HF, and accurately reflect the magnitude of physiologic/clinical improvement following the implementation or titration of an intervention. Cardiopulmonary exercise testing (CPX) satisfies all of the aforementioned desirable assessment attributes. Peak oxygen consumption and the minute ventilation/carbon dioxide production slope are key CPX variables in assessing prognosis and gauging disease severity. Given the high value of information obtained from this procedure, CPX should be considered a core assessment in the HF population. The current review will concisely define key CPX variables and summarize their clinical applications in patients with HF.
尽管心力衰竭(HF)治疗取得了进展,使生存率有所提高,但总体预后仍然较差。鉴于短期死亡率较高,在这一患者群体中使用具有既定预后价值的评估技术仍然很重要。理想情况下,特定评估还应能够准确反映疾病严重程度(这在HF患者中是一种异质性现象),并准确反映干预措施实施或调整后生理/临床改善的程度。心肺运动试验(CPX)满足上述所有理想的评估属性。峰值耗氧量和分钟通气量/二氧化碳产生斜率是评估预后和衡量疾病严重程度的关键CPX变量。鉴于从该检查中获得的信息价值较高,CPX应被视为HF人群的核心评估。本综述将简要定义关键CPX变量,并总结其在HF患者中的临床应用。