Heart Center and Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden; Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
Center for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, Gävle, Sweden.
Can J Cardiol. 2019 Dec;35(12):1815-1823. doi: 10.1016/j.cjca.2019.05.001. Epub 2019 May 7.
Adults with complex congenital heart disease (CHD) show reduced aerobic exercise capacity and impaired skeletal muscle function compared with healthy peers. Peripheral muscle factors are presumed to be important contributors to the aerobic capacity, but the mechanisms are poorly understood. The aim of the present study was to investigate differences between adults with CHD and controls in muscle oxygenation kinetics at rest, and during and after exercise.
Seventy-four patients with complex CHD (mean age 35.6 ± 14.3 years, female n = 22) were recruited. Seventy-four age- and sex-matched subjects were recruited as controls. Muscle oxygenation was successfully determined on the anterior portion of the deltoid muscle using near-infrared spectroscopy in 65 patients and 71 controls. Measurements were made at rest, during isotonic shoulder flexions (0-90°) to exhaustion, and during recovery.
The patients with CHD performed fewer shoulder flexions (40 ± 17 vs 69 ± 40; P < 0.001), had lower muscle oxygen saturation (StO) at rest (58 ± 18% vs 69 ± 18%; P < 0.001), slower desaturation rate at exercise onset (-9.7 ± 5.9 vs -15.1 ± 6.5% StO × 3.5 s, P <0.001), and slower resaturation rate post exercise (4.0 ± 2.7 vs 5.4 ± 3.6% StO × 3.5 s; P = 0.009) compared with the controls.
In comparison with age- and sex-matched controls, adults with complex CHD had slower oxygenation kinetics. This altered skeletal muscle metabolism might contribute to the impaired skeletal muscle endurance capacity shown and thereby also to the reduced aerobic capacity in this population.
与健康同龄人相比，患有复杂先天性心脏病 (CHD) 的成年人的有氧运动能力降低，骨骼肌功能受损。外周肌肉因素被认为是有氧运动能力的重要贡献者，但机制尚不清楚。本研究旨在探讨 CHD 成人与对照组在休息时、运动中和运动后肌肉氧合动力学的差异。
招募了 74 名患有复杂 CHD 的患者（平均年龄 35.6 ± 14.3 岁，女性 n = 22）。招募了 74 名年龄和性别匹配的受试者作为对照组。使用近红外光谱技术成功地在 65 名患者和 71 名对照者的三角肌前部分别确定了肌肉氧合情况。在休息时、等长肩部屈伸运动（0-90°）至疲劳时以及恢复时进行测量。
CHD 患者的肩部屈伸次数较少（40 ± 17 次比 69 ± 40 次；P < 0.001），休息时肌肉氧饱和度（StO）较低（58 ± 18%比 69 ± 18%；P < 0.001），运动起始时的去饱和率较慢（-9.7 ± 5.9% StO×3.5 s 比-15.1 ± 6.5% StO×3.5 s；P < 0.001），运动后再饱和率较慢（4.0 ± 2.7% StO×3.5 s 比 5.4 ± 3.6% StO×3.5 s；P = 0.009）与对照组相比。
与年龄和性别匹配的对照组相比，患有复杂 CHD 的成年人的氧合动力学较慢。这种改变的骨骼肌代谢可能导致该人群骨骼肌耐力能力受损，从而也导致有氧运动能力降低。
