在接受治疗的阻塞性睡眠呼吸暂停肥胖患者中，现场行走测试是否会产生与递增跑步机测试相似的心肺需求？

Do field walking tests produce similar cardiopulmonary demands to an incremental treadmill test in obese individuals with treated OSA?

机构信息

Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, England; Department of Medicine, University of Toronto, Toronto, ON, Canada.

Department of Respiratory Diagnostic & Evaluation Services, West Park Healthcare Centre, Toronto, ON, Canada; Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada.

出版信息

Chest. 2014 Jul;146(1):81-87. doi: 10.1378/chest.13-2060.

DOI:10.1378/chest.13-2060

PMID:24577643

Abstract

BACKGROUND

Cardiorespiratory fitness, assessed during cardiopulmonary exercise tests by peak oxygen uptake (Vo2pk), is an independent predictor of mortality in obesity. We investigated whether Vo2pk and systemic responses measured during field walking tests were similar to those measured during an incremental treadmill test (ITMT) in obese individuals with treated OSA.

METHODS

Individuals with treated OSA and a BMI > 30 kg/m2 were recruited. Participants completed an ITMT, two 6-min walk tests (6MWTs), and two incremental shuttle walk tests (ISWTs) on three separate days in a randomized order. Expired gas analysis was performed during all tests.

RESULTS

The study was completed by 16 patients (nine men) (mean [SD] age, 58 [12] y; BMI, 36.1 [7.6] kg/m2). There was no difference (P = .27) in Vo2pk assessed by the ITMT and the ISWT (2,266 [478] and 2,017 [561] mL/min, respectively). The Vo2pk measured by the 6MWT (1,778 [360] mL/min) was lower than that measured by the ITMT (P < .01). The limits of agreement for Vo2pk between the ISWT and the ITM were ± 730 mL/min. Cardiorespiratory responses during the ISWT and the ITMT reflected a graded response to a peak, whereas the 6MWT demonstrated a rapid rise to a plateau.

CONCLUSIONS

The ISWT can be used instead of an ITMT and in preference to the 6MWT to assess cardiorespiratory fitness for a cohort of obese people with treated OSA. However, the imprecision of the agreement in Vo2pk between the ITMT and ISWT means they cannot be used interchangeably in an individual.

TRIAL REGISTRY

ClinicalTrials.gov; No.: NCT01930513; www.clinicaltrials.gov.

摘要

背景

心肺适能通过最大摄氧量（Vo2pk）评估，是肥胖患者死亡率的独立预测因子。我们研究了经治疗的阻塞性睡眠呼吸暂停（OSA）肥胖患者在进行递增跑步机测试（ITMT）时，Vo2pk 和系统反应与在现场步行测试中测量到的反应是否相似。

方法

招募了患有经治疗的 OSA 和 BMI>30kg/m2 的个体。参与者在 3 天内以随机顺序完成了 ITMT、2 次 6 分钟步行测试（6MWT）和 2 次递增穿梭步行测试（ISWT）。在所有测试中均进行了呼气分析。

结果

该研究由 16 名患者（9 名男性）（平均[标准差]年龄 58[12]岁；BMI 36.1[7.6]kg/m2）完成。ITMT 和 ISWT 评估的 Vo2pk 无差异（P=0.27）（分别为 2266[478]和 2017[561]mL/min）。6MWT 测量的 Vo2pk（1778[360]mL/min）低于 ITMT（P<0.01）。ISWT 和 ITMT 之间 Vo2pk 的一致性范围为±730mL/min。ISWT 和 ITMT 期间的心肺反应反映了向峰值的逐渐增加，而 6MWT 则表现出迅速增加到平台的反应。