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韩国老年心血管疾病患者心肺运动试验的特征与安全性

Characteristics and Safety of Cardiopulmonary Exercise Testing in Elderly Patients with Cardiovascular Diseases in Korea.

作者信息

Kim Bong Joon, Kim Youngju, Oh Jaewon, Jang Jihun, Kang Seok Min

机构信息

Cardiology Division, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea.

Cardiology Division, Severance Cardiovascular Hospital, Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Yonsei Med J. 2019 Jun;60(6):547-553. doi: 10.3349/ymj.2019.60.6.547.

Abstract

PURPOSE

Clinical use of cardiopulmonary exercise tests (CPETs) is increasing in elderly patients with cardiovascular (CV) diseases. However, data on Korean populations are limited. In this study, we aimed to examine the characteristics and safety of CPET in an elderly Korean population with CV disease.

MATERIALS AND METHODS

We retrospectively analyzed records of 1485 patients (older than 65 years in age, with various underlying CV diseases) who underwent CPET. All CPET was performed using the modified Bruce ramp protocol.

RESULTS

The mean age of patients was 71.6±4.7 years with 63.9% being men, 567 patients aged 60-65 years, 818 patients aged 70-79 years, and 100 patients aged 80-89 years. The mean respiratory exchange ratio was 1.09±0.14. During CPET, three adverse cardiovascular events occurred (total 0.20%), all ventricular tachycardia. All subjects showed an average exercise capacity of 21.3±5.5 mL/kg/min at peak VO₂ and 6.1±1.6 metabolic equivalents of task, and men showed better exercise capacity than women on most CEPT parameters. A significant difference was seen in peak oxygen uptake according to age group (65-69 years, 22.9±5.8; 70-79 years, 20.7±5.1; 80-89 years, 17.0±4.5 mL/kg/min, <0.001). The most common causes for CPET termination were dyspnea (64.8%) and leg pain (24.3%), with higher incidence of leg pain in octogenarians compared to other age groups (65-69 years, 22.4%; 70-79 years, 24.6%; 80-89 years, 32.0%, <0.001).

CONCLUSION

CPET was relatively a safe and useful modality to assess exercise capacity, even in an elderly Korean population with underlying CV diseases.

摘要

目的

心肺运动试验(CPET)在老年心血管疾病(CV)患者中的临床应用日益增加。然而,关于韩国人群的数据有限。在本研究中,我们旨在探讨CPET在患有CV疾病的韩国老年人群中的特征和安全性。

材料与方法

我们回顾性分析了1485例接受CPET的患者(年龄大于65岁,患有各种潜在CV疾病)的记录。所有CPET均采用改良的Bruce斜坡方案进行。

结果

患者的平均年龄为71.6±4.7岁,男性占63.9%,567例患者年龄在60 - 65岁,818例患者年龄在70 - 79岁,100例患者年龄在80 - 89岁。平均呼吸交换率为1.09±0.14。在CPET期间,发生了3例不良心血管事件(总计0.20%),均为室性心动过速。所有受试者在峰值VO₂时的平均运动能力为21.3±5.5 mL/kg/min,任务代谢当量为6.1±1.6,并且在大多数CEPT参数上男性的运动能力优于女性。根据年龄组,峰值摄氧量存在显著差异(65 - 69岁,22.9±5.8;70 - 79岁,20.7±5.1;80 - 89岁,17.0±4.5 mL/kg/min,<0.001)。CPET终止的最常见原因是呼吸困难(64.8%)和腿痛(24.3%),与其他年龄组相比,八旬老人中腿痛的发生率更高(65 - 69岁,22.4%;70 - 79岁,24.6%;80 - 89岁,32.0%,<0.001)。

结论

即使在患有潜在CV疾病的韩国老年人群中,CPET也是评估运动能力的一种相对安全且有用的方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3564/6536393/f8fdfc7a4b1a/ymj-60-547-g001.jpg

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