Uithoven Katelyn E, Smith Joshua R, Medina-Inojosa Jose R, Squires Ray W, Van Iterson Erik H, Olson Thomas P
School of Kinesiology, University of Minnesota, Minneapolis, MN 55455, USA.
Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA.
J Clin Med. 2019 Jan 19;8(1):119. doi: 10.3390/jcm8010119.
The measurement of peak oxygen uptake (VO) is an important metric for evaluating cardiac transplantation (HTx) eligibility. However, it is unclear which factors (e.g., recipient demographics, clinical parameters, cardiac rehabilitation (CR) participation) influence VO following HTx. Consecutive HTx patients with cardiopulmonary exercise testing (CPET) between 2007⁻2016 were included. VO was measured from CPET standard protocol. Regression analyses determined predictors of the highest post-HTx VO (i.e., quartile 4: VO > 20.1 mL/kg/min). One hundred-forty HTx patients (women: = 41 (29%), age: 52 ± 12 years, body mass index (BMI): 27 ± 5 kg/m²) were included. History of diabetes (Odds Ratio (OR): 0.17, 95% Confidence Interval (CI): 0.04⁻0.77, = 0.021), history of dyslipidemia (OR: 0.42, 95% CI: 0.19⁻0.93, = 0.032), BMI (OR: 0.90, 95% CI: 0.82⁻0.99, = 0.022), hemoglobin (OR: 1.29, 95% CI: 1.04⁻1.61, = 0.020), white blood cell count (OR: 0.81, 95% CI: 0.66⁻0.98, = 0.033), CR exercise sessions (OR: 1.10, 95% CI: 1.04⁻1.15, < 0.001), and pre-HTx VO (OR: 1.17, 95% CI: 1.07⁻1.29, = 0.001) were significant predictors. Multivariate analysis showed CR exercise sessions (OR: 1.10, 95% CI: 1.03⁻1.16, = 0.002), and pre-HTx VO (OR: 1.16, 95% CI: 1.04⁻1.30, = 0.007) were independently predictive of higher post-HTx VO. Pre-HTx VO and CR exercise sessions are predictive of a greater VO following HTx. These data highlight the importance of CR exercise session attendance and pre-HTx fitness in predicting VO post-HTx.
峰值摄氧量（VO）的测量是评估心脏移植（HTx）适用性的一项重要指标。然而，目前尚不清楚哪些因素（如受者人口统计学特征、临床参数、心脏康复（CR）参与情况）会影响HTx后的VO。纳入了2007年至2016年间连续接受心肺运动试验（CPET）的HTx患者。VO通过CPET标准方案进行测量。回归分析确定了HTx后最高VO（即四分位数4：VO>20.1 mL/kg/min）的预测因素。共纳入140例HTx患者（女性：41例（29%），年龄：52±12岁，体重指数（BMI）：27±5 kg/m²）。糖尿病史（优势比（OR）：0.17，95%置信区间（CI）：0.04至0.77，P = 0.021）、血脂异常史（OR：0.42，95%CI：0.19至0.93，P = 0.032）、BMI（OR：0.90，95%CI：0.82至0.99，P = 0.022）、血红蛋白（OR：1.29，95%CI：1.04至1.61，P = 0.020）、白细胞计数（OR：0.81，95%CI：0.66至0.98，P = 0.033）、CR运动疗程（OR：1.10，95%CI：1.04至1.15，P<0.001）以及HTx前VO（OR：1.17，95%CI：1.07至1.29，P = 0.001）均为显著预测因素。多变量分析显示，CR运动疗程（OR：1.10，95%CI：1.03至1.16，P = 0.002）以及HTx前VO（OR：1.16，95%CI：1.04至1.30，P = 0.007）可独立预测HTx后更高的VO。HTx前VO和CR运动疗程可预测HTx后更大的VO。这些数据突出了CR运动疗程参与情况和HTx前身体适应性在预测HTx后VO方面的重要性。
