Pulmonary Function and Exercise Physiology Unit. Division of Respiratory Diseases, Department of Medicine, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil.
Pulmonary Function and Exercise Physiology Unit. Division of Respiratory Diseases, Department of Medicine, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil.
Respir Physiol Neurobiol. 2020 Jan;271:103307. doi: 10.1016/j.resp.2019.103307. Epub 2019 Sep 23.
Cardiopulmonary exercise testing (CPET) on a treadmill or cycle ergometer provides an integrated assessment of the cardiorespiratory system during exertion and is widely used in clinical practice. An incremental step test (IST) can be an alternative for eliciting maximal exercise responses. Therefore, 20 patients with pre-capillary PH (65% female, 41 ± 15 yrs) randomly performed a symptom-limited CPET on a cycle ergometer and IST. Metabolic, cardiovascular, ventilatory and gas exchange variables were recorded during both tests. There was a greater desaturation and higher V̇O in IST compared to CPET. The V̇O HR (% pred), ΔV̇E/ΔV̇CO and ΔHR/ΔV̇O were similar in both IST and CPET. By linear regression analyses, the work performed on IST [W = (mass × 9,8 m/s2 x vertical distance)] was a predictor of peak V̇O independent of the gender and age (r = 077, p = 0001). In conclusion, IST elicited higher peak cardiopulmonary responses and has a good agreement with known severity markers in patients with pre-capillary PH.
心肺运动测试（CPET）在跑步机或功率自行车上进行，可在运动过程中对心肺系统进行综合评估，在临床实践中得到广泛应用。递增负荷试验（IST）可作为诱发最大运动反应的替代方法。因此，20 例毛细血管前 PH 患者（女性占 65%，41±15 岁）随机在功率自行车上进行了症状限制的 CPET 和 IST。在这两种测试中都记录了代谢、心血管、通气和气体交换变量。与 CPET 相比，IST 中出现了更大的血氧饱和度下降和更高的 VO₂。IST 和 CPET 中的 VO₂HR（%预测值）、ΔVE/ΔVCO 和 ΔHR/ΔVO₂相似。通过线性回归分析，IST 上完成的功[W=（质量×9.8 m/s²x 垂直距离）]是预测峰值 VO₂的独立因素，与性别和年龄无关（r=0.77，p=0.0001）。总之，IST 可诱发更高的心肺反应峰值，与毛细血管前 PH 患者的已知严重程度标志物具有良好的一致性。
