Itoh H, Taniguchi K, Koike A, Doi M
Second Department of Internal Medicine, Tokyo Medical and Dental University, Japan.
Circulation. 1990 Jan;81(1 Suppl):II31-7.
To evaluate the severity of heart failure, cardiopulmonary exercise testing was performed in 99 normal subjects and in 382 patients with cardiac disease. Anaerobic threshold, peak oxygen uptake, and the ratio of increase in oxygen uptake to work-rate increment were determined by ventilatory and gas exchange measurements as indexes for assessing the severity of heart failure. Anaerobic threshold and peak oxygen uptake declined with age, and males showed higher values than females in both indexes. Anaerobic threshold, as the percentage of predicted value for age, sex, and body weight, decreased as New York Heart Association (NYHA) class increased as follows: 90.2 +/- 15.4% in class I, 76.9 +/- 13.8% in class II, and 59.7 +/- 11.9% in class III (mean +/- SD). Although the ratio of increase in oxygen uptake to work-rate increment was not influenced by age or sex, it decreased as the severity of heart disease progressed. These results suggest that indexes from cardiopulmonary exercise testing are closely related to the pathophysiology of heart failure. We conclude that these indexes can be used as objective and reliable parameters for evaluation of the severity of heart failure in terms of functional capacity.
为评估心力衰竭的严重程度，对99名正常受试者和382名心脏病患者进行了心肺运动试验。通过通气和气体交换测量来确定无氧阈值、峰值摄氧量以及摄氧量增加与工作负荷增加的比值，以此作为评估心力衰竭严重程度的指标。无氧阈值和峰值摄氧量随年龄下降，且在这两个指标上男性的值均高于女性。无氧阈值作为年龄、性别和体重预测值的百分比，随着纽约心脏协会（NYHA）心功能分级的增加而降低，具体如下：I级为90.2±15.4%，II级为76.9±13.8%，III级为59.7±11.9%（均值±标准差）。尽管摄氧量增加与工作负荷增加的比值不受年龄或性别的影响，但随着心脏病严重程度的进展而降低。这些结果表明，心肺运动试验的指标与心力衰竭的病理生理学密切相关。我们得出结论，就功能能力而言，这些指标可作为评估心力衰竭严重程度的客观可靠参数。
