Division of Cardiovascular Diseases and Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Circulation. 2012 Nov 20;126(21):2465-72. doi: 10.1161/CIRCULATIONAHA.112.110460. Epub 2012 Oct 22.
Cardiopulmonary exercise testing (CPX) with measurement of peak oxygen uptake (Vo(2)) is a powerful test for assessment and quantification of functional impairment resulting from cardiovascular disease. The safety of CPX has been established in patients with coronary artery disease and congestive heart failure, but clinical use of CPX in other cardiac diseases has been limited, in part because of a paucity of safety data. This study investigates the safety of CPX in a heterogeneous cohort of patients with a wide variety of underlying high-risk cardiac diagnoses.
This single-center retrospective review examined 5060 CPX studies performed in 4250 unique patients, including 1748 (35%) female subjects and 686 (14%) subjects aged ≥75 years. The primary end point was major adverse event during stress testing. The study population included patients with a variety of high-risk cardiac diseases, including congestive heart failure (n=1289, 25.5%), hypertrophic cardiomyopathy (n=598, 11.8%), pulmonary hypertension (n=194, 3.8%), and aortic stenosis (n=212, 4.2%). This patient population generally had severe functional impairment, including 1192 (24%) patients with peak Vo(2)<14 mL/kg/min. Eight adverse events occurred during CPX, for an adverse event rate of 0.16%. The most common adverse event (n=6) was sustained ventricular tachycardia. There were no fatal events.
CPX is generally a safe procedure, even in a population with underlying high-risk cardiovascular diagnoses.
心肺运动测试（CPX）结合峰值摄氧量（Vo(2)）的测量是评估和量化心血管疾病导致的功能障碍的有力测试。CPX 在冠状动脉疾病和充血性心力衰竭患者中的安全性已经得到确立，但由于缺乏安全性数据，CPX 在其他心脏疾病中的临床应用受到限制。本研究调查了 CPX 在患有各种潜在高危心脏诊断的异质患者队列中的安全性。
这项单中心回顾性研究检查了 4250 名患者中的 5060 次 CPX 研究，其中包括 1748 名（35%）女性和 686 名（14%）年龄≥75 岁的患者。主要终点是应激测试期间的主要不良事件。研究人群包括患有各种高危心脏疾病的患者，包括充血性心力衰竭（n=1289，25.5%）、肥厚型心肌病（n=598，11.8%）、肺动脉高压（n=194，3.8%）和主动脉瓣狭窄（n=212，4.2%）。这些患者人群通常存在严重的功能障碍，包括 1192 名（24%）患者的峰值 Vo(2)<14 mL/kg/min。CPX 期间发生了 8 次不良事件，不良事件发生率为 0.16%。最常见的不良事件（n=6）是持续性室性心动过速。没有致命事件。
CPX 通常是一种安全的程序，即使在患有潜在高危心血管诊断的人群中也是如此。
