Boss H Myrthe, Deijle Inger A, Van Schaik Sander M, de Melker Edwin C, van den Berg Bob T J, Weinstein Henry C, Geerlings Mirjam I, Kappelle L Jaap, Van den Berg-Vos Renske M
Department of Neurology, OLVG West, Amsterdam, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Neurology, University Medical Center Utrecht, Utrecht, The Netherlands.
Department of Physical Therapy, OLVG West, Amsterdam, The Netherlands.
J Stroke Cerebrovasc Dis. 2017 May;26(5):1114-1120. doi: 10.1016/j.jstrokecerebrovasdis.2016.12.029. Epub 2017 Jan 12.
Cardiorespiratory fitness (CRF) is reduced in patients with stroke. It is unclear whether it is also reduced in patients with a transient ischemic attack (TIA) or minor stroke. We investigated the CRF in patients with a recent TIA or minor stroke and explored which determinants are associated with a lower fitness.
In 113 patients with a recent TIA or minor ischemic stroke (64 (SD = 10) years of age; 49 (IQR 27-86) days post TIA or stroke), the peak oxygen consumption (VO2peak) was determined in a symptom-limited ramp exercise test. Physical activity level, vascular risk factors, history of vascular or pulmonary disease, and stroke characteristics were recorded at inclusion and related to the VO2peak.
Mean VO2peak was 22 mL/kg/min (SD = 6), which is the fifth percentile of age- and sex-related normative values. Increasing age and female sex were associated with a lower VO2peak (B (95% CI): per 10 years -2.57 mL/kg/min (-3.75; -1.40) and female sex -5.84 mL/kg/min (-8.06; -3.62)). Age- and sex-adjusted linear regression analyses showed that a history of cardiovascular disease and pulmonary disease was associated with a lower VO2peak. In addition, a lower level of physical activity, hypertension, smoking, and overweight were associated with a lower VO2peak. History of stroke and stroke characteristics were not related to VO2peak.
The majority of patients with a recent TIA or minor ischemic stroke have a poor CRF. Our findings suggest that premorbid cardiovascular and pulmonary disease and vascular risk factors, but not TIA- or stroke-related factors, contribute to a reduced CRF.
中风患者的心肺适能（CRF）会降低。目前尚不清楚短暂性脑缺血发作（TIA）或轻度中风患者的心肺适能是否也会降低。我们调查了近期发生TIA或轻度中风患者的心肺适能，并探讨了哪些决定因素与较低的适能相关。
在113例近期发生TIA或轻度缺血性中风的患者（年龄64（标准差=10）岁；TIA或中风后49（四分位间距27-86）天）中，通过症状限制递增运动试验测定峰值耗氧量（VO2peak）。在纳入研究时记录身体活动水平、血管危险因素、血管或肺部疾病史以及中风特征，并将其与VO2peak相关联。
平均VO2peak为22 mL/kg/min（标准差=6），处于年龄和性别相关标准值的第五百分位数。年龄增加和女性与较低的VO2peak相关（B（95%置信区间）：每增加10岁-2.57 mL/kg/min（-3.75；-1.40），女性为-5.84 mL/kg/min（-8.06；-3.62））。年龄和性别调整后的线性回归分析表明，心血管疾病和肺部疾病史与较低的VO2peak相关。此外，较低的身体活动水平、高血压、吸烟和超重与较低的VO2peak相关。中风病史和中风特征与VO2peak无关。
大多数近期发生TIA或轻度缺血性中风的患者心肺适能较差。我们的研究结果表明，病前心血管和肺部疾病以及血管危险因素，而非TIA或中风相关因素，导致了心肺适能降低。
