Department of Structural and Congenital Cardiology, University Hospitals Leuven, Belgium.
J Cardiopulm Rehabil Prev. 2011 Sep-Oct;31(5):308-15. doi: 10.1097/HCR.0b013e318220a805.
Although exercise capacity is impaired, atrial septal defect (ASD) patients report satisfactory exercise tolerance. This study aimed at (1) evaluating cardiopulmonary exercise testing (CPX) and (2) evaluating the impact of exercise capacity on perceived health status using a self-reported health questionnaire (SF-36) in patients with open and closed ASD.
Seventeen patients (mean age 37 ± 17, 9 males) with open ASD and 24 (mean age 37 ± 14, 6 male) with closed ASD were included. All underwent CPX and completed a SF-36 questionnaire. Age- and gender-matched controls were selected for comparison of CPX variables and SF-36 was compared with results from a general population.
Patients with open ASD had lower peak oxygen uptake (VO(2)) (27.9 ± 9.7 vs 38.5 ± 9.5 mL · kg(-1) · min(-1). P = .009) and higher VE/VCO(2) slope (31.0 ± 7.7 vs 24.1 ± 4.8; P = .004) than controls. Patients with closed ASD had lower peak VO(2) (26.2 ± 8.4 vs 34.8 ± 9.7 mL · kg(-1) · min(-1). P = .014) and peak heart rate (163 ± 25 vs 178 ± 16 bpm; P = .035) than controls. Perceived health-status was lower in patients with open ASD than the general population. Peak VO(2) correlated significantly with physical functioning, emotional functioning, and bodily pain in open ASD and with physical functioning, bodily pain, role limitation, vitality, and mental health in closed ASD patients.
Patients with open and closed ASD had decreased peak VO(2). Patients with open ASD had lower ventilatory efficiency. Closed ASD patients had chronotropic incompetence because of β-blockers. SF-36 was reduced in patients with open ASD but not closed ASD. Reduced exercise capacity affected several domains of perceived health-status in ASD patients.
尽管运动能力受损，但房间隔缺损（ASD）患者报告其运动耐量令人满意。本研究旨在（1）评估心肺运动试验（CPX）和（2）使用自我报告健康问卷（SF-36）评估运动能力对 ASD 患者感知健康状况的影响。
纳入 17 名开放性 ASD 患者（平均年龄 37 ± 17 岁，9 名男性）和 24 名闭合性 ASD 患者（平均年龄 37 ± 14 岁，6 名男性）。所有患者均进行 CPX 检查，并完成 SF-36 问卷。选择年龄和性别匹配的对照者进行 CPX 变量比较，并将 SF-36 与一般人群的结果进行比较。
开放性 ASD 患者的峰值摄氧量（VO₂）（27.9 ± 9.7 比 38.5 ± 9.5 mL·kg⁻¹·min⁻¹，P =.009）和 VE/VCO₂斜率（31.0 ± 7.7 比 24.1 ± 4.8，P =.004）低于对照者。闭合性 ASD 患者的峰值 VO₂（26.2 ± 8.4 比 34.8 ± 9.7 mL·kg⁻¹·min⁻¹，P =.014）和峰值心率（163 ± 25 比 178 ± 16 bpm，P =.035）低于对照者。开放性 ASD 患者的感知健康状况低于一般人群。在开放性 ASD 患者中，峰值 VO₂与身体机能、情感功能和身体疼痛显著相关，在闭合性 ASD 患者中与身体机能、身体疼痛、角色限制、活力和心理健康显著相关。
开放性 ASD 和闭合性 ASD 患者的峰值 VO₂均降低。开放性 ASD 患者的通气效率降低。由于β受体阻滞剂的作用，闭合性 ASD 患者的变时功能不全。开放性 ASD 患者的 SF-36 评分降低，但闭合性 ASD 患者没有降低。运动能力降低影响 ASD 患者感知健康状况的多个领域。
