心力衰竭患者最大运动后峰值摄氧量恢复延迟。
Peak Oxygen Uptake Recovery Delay After Maximal Exercise in Patients With Heart Failure.
机构信息
VCU Pauley Heart Center, Virginia Commonwealth University, Richmond (Drs Kadariya, Canada, Del Buono, Tchoukina, and Abbate and Ms van Wezenbeek); Department of Pharmacotherapy and Outcome Sciences, Virginia Commonwealth University, Richmond (Dr Van Tassell); and Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago (Dr Arena). The first two authors equally contributed to the realization of this manuscript.
出版信息
J Cardiopulm Rehabil Prev. 2020 Nov;40(6):434-437. doi: 10.1097/HCR.0000000000000502.
PURPOSE
Peak oxygen uptake recovery delay (V˙o2peakRD), measured as the time until post-exercise oxygen uptake (V˙o2) decreases below V˙o2peak following maximal cardiopulmonary exercise testing (CPX), has been recognized as an abnormal response, associated with reduced cardiac output reserve during exercise in patients with heart failure (HF). In the current study we examined the association of V˙o2peakRD during routine CPX testing of patients with symptomatic HF across a wide range of left ventricular ejection fraction (LVEF) values with clinical biomarkers.
METHODS
In this retrospective study, 80 clinically stable symptomatic HF patients across a wide range of LVEF at our institution were evaluated that put forth a minimally acceptable effort during CPX testing (respiratory exchange ratio ≥ 1.00). The V˙o2peakRD was measured in 10-sec intervals following maximal CPX testing. Markers of elevated cardiac filling pressures (N-terminal pro-brain natriuretic peptide [NTproBNP] and echocardio-Doppler E/e') and other key CPX parameters were explored for their association with V˙o2peakRD.
RESULTS
The mean V˙o2peakRD and V˙o2peak were 10 (interquartile range 10, 40) sec and 13.9 (11.6, 16.4) mL· kg · min, respectively. V˙o2peakRD demonstrated a positive linear trend with serum NTproBNP levels and E/e' (TJT = 1239.500, z = 2.634, P < .01; TJT = 1081.000, z = 2.046, P = .04, respectively).
CONCLUSION
Prolonged V˙o2peakRD following exercise is associated with markers of greater disease severity in patients with HF.
目的
最大心肺运动测试（CPX）后，摄氧量（V˙o2）降至 V˙o2peak 以下的时间（即 V˙o2peakRD）被认为是异常反应，与心力衰竭（HF）患者运动时心输出量储备减少有关。在目前的研究中，我们检查了在我们机构接受症状性 HF 常规 CPX 测试的患者中，V˙o2peakRD 与广泛左心室射血分数（LVEF）范围内的临床生物标志物的相关性。
方法
在这项回顾性研究中，我们评估了在我们机构接受 CPX 测试的 80 例具有广泛 LVEF 的临床稳定的症状性 HF 患者，这些患者在 CPX 测试中表现出最小可接受的努力（呼吸交换比≥1.00）。在最大 CPX 测试后 10 秒间隔测量 V˙o2peakRD。探讨了升高的心脏充盈压标志物（N 端脑利钠肽前体[NTproBNP]和超声心动图多普勒 E/e'）和其他关键 CPX 参数与 V˙o2peakRD 的相关性。
结果
平均 V˙o2peakRD 和 V˙o2peak 分别为 10（四分位距 10，40）秒和 13.9（11.6，16.4）mL·kg·min。V˙o2peakRD 与血清 NTproBNP 水平和 E/e'呈正线性趋势（TJT=1239.500，z=2.634，P<.01；TJT=1081.000，z=2.046，P=0.04）。
结论
HF 患者运动后 V˙o2peakRD 延长与疾病严重程度标志物相关。
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