Tsai Yun-Jeng, Li Min-Hui, Tsai Wan-Jung, Tuan Sheng-Hui, Liao Tin-Yun, Lin Ko-Long
Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Eur J Prev Cardiol. 2016 Jul;23(10):1045-50. doi: 10.1177/2047487315623405. Epub 2015 Dec 23.
Oxygen uptake efficiency slope (OUES) and peak oxygen consumption (VO2peak) are exercise parameters that can predict cardiac morbidity in patients with numerous heart diseases. But the predictive value in patients with tetralogy of Fallot is still undetermined, especially in children. We evaluated the prognostic value of OUES and VO2peak in children with total repair of tetralogy of Fallot.
Retrospective cohort study.
Forty tetralogy of Fallot patients younger than 12 years old were recruited. They underwent a cardiopulmonary exercise test during the follow-up period after total repair surgery. The results of the cardiopulmonary exercise test were used to predict the cardiac related hospitalization in the following two years after the test.
OUES normalized by body surface area (OUES/BSA) and the percentage of predicted VO2peak appeared to be predictive for two-year cardiac related hospitalization. Receiver operating characteristic curve analysis demonstrated that the best threshold value for OUES/BSA was 1.029 (area under the curve = 0.70, p = 0.03), and for VO2peak was 74% of age prediction (area under the curve = 0.72, p = 0.02). The aforementioned findings were confirmed by Kaplan-Meier plots and log-rank test.
OUES/BSA and VO2peak are useful predictors of cardiac-related hospitalization in children with total repair of tetralogy of Fallot.
摄氧效率斜率（OUES）和峰值耗氧量（VO2peak）是可预测多种心脏病患者心脏发病率的运动参数。但法洛四联症患者的预测价值仍未确定，尤其是儿童患者。我们评估了OUES和VO2peak对法洛四联症根治术后儿童患者的预后价值。
回顾性队列研究。
招募了40名12岁以下的法洛四联症患者。他们在根治手术后的随访期间接受了心肺运动试验。心肺运动试验结果用于预测试验后接下来两年内与心脏相关的住院情况。
经体表面积标准化的OUES（OUES/BSA）和预测VO2peak的百分比似乎可预测两年内与心脏相关的住院情况。受试者工作特征曲线分析表明，OUES/BSA的最佳阈值为1.029（曲线下面积=0.70，p=0.03），VO2peak的最佳阈值为年龄预测值的74%（曲线下面积=0.72，p=0.02）。上述结果通过Kaplan-Meier曲线和对数秩检验得到证实。
OUES/BSA和VO2peak是法洛四联症根治术后儿童患者与心脏相关住院情况的有用预测指标。
