Takano Nami, Amiya Eisuke, Oguri Gaku, Nakayama Atsuko, Taya Masanobu, Nakajima Toshiaki, Morita Hiroyuki, Komuro Issei
Department of Cardiovascular Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan.
Center for Health Check-up and Preventive Medicine, Kanto Central Hospital, 6-25-1 Kamiyoga, Setagaya-ku, Tokyo, Japan.
Int J Cardiol Heart Vasc. 2019 Jan 8;22:84-91. doi: 10.1016/j.ijcha.2018.12.014. eCollection 2019 Mar.
To investigate the effect of atrial fibrillation (AF) on the oxygen uptake and exercise tolerance, we evaluated cardiopulmonary exercise test (CPET) data in AF patients and heart rate-matched controls with sinus rhythm (cSR) who received ambulatory cardiac rehabilitation. We compared CPET data between AF ( = 27) and cSR patients ( = 106) who had similar HRs at rest and the peak points. Oxygen uptake (VO)/kg and relative O pulse (ml/bpm/kg) at rest and the anaerobic threshold (AT) level was not different between AF and cSR patients, but these parameters above the AT level were significantly lower in AF than in cSR patients. Concisely the parallel increase of relative O pulse during exercise was blunted above the respiratory compensation level (Rc) in the AF group. In addition, the HR change during exercise was inversely correlated with the increase of the O pulse above the AT level and this inverse correlation was more prominent in AF patients than in cSR patients. In conclusion, the value of VO was significantly lower above the AT level in AF patients. The trend of O pulse above the AT level was strongly associated with the detrimental response of HR increase and the response was markedly exaggerated in the AF patients.
为研究心房颤动（AF）对摄氧量和运动耐力的影响，我们评估了接受门诊心脏康复治疗的AF患者和心率匹配的窦性心律（cSR）对照者的心肺运动试验（CPET）数据。我们比较了静息心率和峰值心率相似的AF患者（n = 27）和cSR患者（n = 106）的CPET数据。AF患者和cSR患者静息时的摄氧量（VO₂）/kg、相对氧脉搏（ml/bpm/kg）以及无氧阈（AT）水平无差异，但AF患者AT水平以上的这些参数显著低于cSR患者。简而言之，AF组运动期间相对氧脉搏在呼吸补偿水平（Rc）以上的平行增加减弱。此外，运动期间心率变化与AT水平以上氧脉搏的增加呈负相关，且这种负相关在AF患者中比在cSR患者中更显著。总之，AF患者AT水平以上VO₂值显著降低。AT水平以上氧脉搏的趋势与心率增加的有害反应密切相关，且该反应在AF患者中明显夸大。
