接受β受体阻滞剂治疗的缺血性和非缺血性心力衰竭患者的与年龄相关的最大心率。

Age-related maximum heart rate among ischemic and nonischemic heart failure patients receiving β-blockade therapy.

机构信息

Heart Institute, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.

出版信息

J Card Fail. 2012 Nov;18(11):831-6. doi: 10.1016/j.cardfail.2012.10.007.

DOI:10.1016/j.cardfail.2012.10.007

PMID:23141855

Abstract

BACKGROUND

Equations to predict maximum heart rate (HR(max)) in heart failure (HF) patients receiving β-adrenergic blocking (BB) agents do not consider the cause of HF. We determined equations to predict HR(max) in patients with ischemic and nonischemic HF receiving BB therapy.

METHODS AND RESULTS

Using treadmill cardiopulmonary exercise testing, we studied HF patients receiving BB therapy being considered for transplantation from 1999 to 2010. Exclusions were pacemaker and/or implantable defibrillator, left ventricle ejection fraction (LVEF) >50%, peak respiratory exchange ratio (RER) <1.00, and Chagas disease. We used linear regression equations to predict HR(max) based on age in ischemic and nonischemic patients. We analyzed 278 patients, aged 47 ± 10 years, with ischemic (n = 75) and nonischemic (n = 203) HF. LVEF was 30.8 ± 9.4% and 28.6 ± 8.2% (P = .04), peak VO(2) 16.9 ± 4.7 and 16.9 ± 5.2 mL kg(-1) min(-1) (P = NS), and the HR(max) 130.8 ± 23.3 and 125.3 ± 25.3 beats/min (P = .051) in ischemic and nonischemic patients, respectively. We devised the equation HR(max) = 168 - 0.76 × age (R(2) = 0.095; P = .007) for ischemic HF patients, but there was no significant relationship between age and HR(max) in nonischemic HF patients (R(2) = 0.006; P = NS).

CONCLUSIONS

Our study suggests that equations to estimate HR(max) should consider the cause of HF.

摘要

背景

用于预测接受β-肾上腺素能阻滞剂（BB）治疗的心力衰竭（HF）患者最大心率（HR(max)）的方程并未考虑 HF 的病因。我们确定了用于预测接受 BB 治疗的缺血性和非缺血性 HF 患者 HR(max)的方程。

方法和结果

使用跑步机心肺运动测试，我们研究了 1999 年至 2010 年期间接受 BB 治疗并考虑进行移植的 HF 患者。排除标准为起搏器和/或植入式除颤器、左心室射血分数（LVEF）>50%、峰值呼吸交换比（RER）<1.00 和恰加斯病。我们使用线性回归方程根据年龄预测缺血性和非缺血性患者的 HR(max)。我们分析了 278 名年龄 47 ± 10 岁的患者，其中缺血性（n=75）和非缺血性（n=203）HF。LVEF 分别为 30.8 ± 9.4%和 28.6 ± 8.2%（P=0.04），峰值 VO(2)分别为 16.9 ± 4.7 和 16.9 ± 5.2 mL kg(-1) min(-1)（P=NS），HR(max)分别为 130.8 ± 23.3 和 125.3 ± 25.3 次/分钟（P=0.051）。我们为缺血性 HF 患者设计了 HR(max) = 168 - 0.76 × 年龄（R(2) = 0.095；P=0.007）的方程，但非缺血性 HF 患者的年龄与 HR(max)之间没有显著关系（R(2) = 0.006；P=NS）。