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通过残余SYNTAX评分客观评估不完全血运重建的程度,并评价不完全血运重建对接受经皮冠状动脉介入治疗的冠心病患者运动耐量的影响。

Objectifying the level of incomplete revascularization by residual SYNTAX score and evaluating the impact of incomplete revascularization on exercise tolerance in patients with coronary atherosclerotic heart disease treated by percutaneous coronary intervention.

作者信息

Xue Lin, Guo Danjie, Wang Lan, Cao Chengfu, Li Qi, Zou Shangzhi

机构信息

Department of Cardiology, Peking University People's Hospital.

Department of Pulmonary Vascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

Medicine (Baltimore). 2020 Sep 18;99(38):e22221. doi: 10.1097/MD.0000000000022221.

Abstract

The prognostic impact of incomplete revascularization (ICR) on patients underwent percutaneous coronary intervention (PCI) was vague. Our research aimed to objectify the level of ICR by residual SYNTAX score (rSS) and evaluate the impact of ICR on exercise tolerance.We enrolled 87 patients who completed cardiopulmonary exercise testing (CPET) within 12 months after PCI, retrospectively. According to rSS, patients were divided into rSS = 0 group, 0 < rSS ≤ 8 group, and rSS > 8 group. The CPET variables--including peak metabolic equivalent (METpeak), percentages of predicting value of METpeak (METpeak%pred), MET at anaerobic threshold (AT), peak oxygen uptake (VO2peak), percentages of predicting value of VO2peak (VO2peak%pred), VO2 at AT--were collected and compared.Among rSS = 0, 0 < rSS ≤ 8 and rSS > 8 groups, patients with higher rSS had progressively lower METpeak, METpeak%pred, VO2peak%pred, VO2 at AT, and MET at AT, which indicate reduced exercise tolerance. And further multiple comparisons showed that there were no statistically significant differences between rSS = 0 and 0 < rSS ≤ 8 groups, while the aforementioned CPET variables were significantly lower in rSS > 8 group compared with rSS = 0 group. Logistic regression analysis showed that rSS was an independent risk factor for reduced exercise tolerance.

摘要

不完全血运重建(ICR)对接受经皮冠状动脉介入治疗(PCI)患者的预后影响尚不明确。我们的研究旨在通过残余SYNTAX评分(rSS)客观化ICR水平,并评估ICR对运动耐量的影响。我们回顾性纳入了87例在PCI术后12个月内完成心肺运动试验(CPET)的患者。根据rSS,患者被分为rSS = 0组、0 < rSS≤8组和rSS>8组。收集并比较CPET变量,包括峰值代谢当量(METpeak)、METpeak预测值百分比(METpeak%pred)、无氧阈时的代谢当量(AT时的MET)、峰值摄氧量(VO2peak)、VO2peak预测值百分比(VO2peak%pred)、AT时的VO2。在rSS = 0组、0 < rSS≤8组和rSS>8组中,rSS越高的患者,其METpeak、METpeak%pred、VO2peak%pred、AT时的VO2和AT时的MET逐渐降低,这表明运动耐量降低。进一步的多重比较显示,rSS = 0组和0 < rSS≤8组之间无统计学显著差异,而与rSS = 0组相比,rSS>8组的上述CPET变量显著更低。逻辑回归分析显示,rSS是运动耐量降低的独立危险因素。

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