Mayo Clinic Hospital, 5777 East Mayo Boulevard, Phoenix, AZ 85054 USA.
J Invasive Cardiol. 2021 Feb;33(2):E100-E107. doi: 10.25270/jic/20.00387.
Oxygen consumption (VO2) is frequently estimated using derived formulas for ease of use. We performed a prospective study to assess the correlation and limits of agreement between measured and assumed VO2 (mL/min) in adults with congenital heart disease (CHD).
Consecutive adults with CHD who have undergone cardiac catheterization at Mayo Clinic Rochester from January 2018 to December 2019 were retrospectively enrolled in the study. Expired gas analysis was performed to measure VO2. We estimated VO2 using LaFarge (VO2L), Dehmer (VO2D), and Bergstra (VO2B) formulas. Bland-Altman and linear-regression analyses were used to assess the correlation between measured and calculated VO2.
We enrolled 84 patients with a mean age of 43 ± 12 years; 66% were men. Linear correlation analysis showed a moderate correlation of VO2L and VO2B with VO2M (r = 0.58; P<.001 and r = 0.44; P<.01, respectively) and good correlation of VO2D with VO2M (r = 0.79; P<.001). The large spread of limits of agreement assessed using Bland-Altman analysis demonstrates poor agreement of VO2L and VO2B with VO2M (bias, -58; 95% confidence interval [CI], -258 to 48) and bias, 38; 95% CI, -91 to 167, respectively). The limits of agreement for VO2D have a large spread, demonstrating a low degree of agreement with VO2M (bias, 13; 95% CI, -64 to 89). VO2L predominantly misclassified patients as low cardiac index and VO2D and VO2B misclassified patients as normal/ high cardiac index.
In adults with CHD, assumed VO2 will lead to a significant error while assessing invasive intracardiac hemodynamics.
为了便于使用，氧气消耗（VO2）通常是通过推导公式来估算的。我们进行了一项前瞻性研究，以评估在接受过心脏导管检查的成人先天性心脏病（CHD）患者中，测量 VO2（毫升/分钟）与假设 VO2（毫升/分钟）之间的相关性和一致性。
回顾性纳入 2018 年 1 月至 2019 年 12 月在梅奥诊所罗切斯特院区接受心脏导管检查的连续成人 CHD 患者。使用呼出气体分析来测量 VO2。我们使用 LaFarge（VO2L）、Dehmer（VO2D）和 Bergstra（VO2B）公式来估计 VO2。使用 Bland-Altman 和线性回归分析来评估测量 VO2 与计算 VO2 之间的相关性。
我们共纳入 84 例患者，平均年龄为 43 ± 12 岁；66%为男性。线性相关分析显示，VO2L 和 VO2B 与 VO2M 呈中度相关（r = 0.58；P<.001 和 r = 0.44；P<.01），VO2D 与 VO2M 呈高度相关（r = 0.79；P<.001）。Bland-Altman 分析评估的一致性范围较大，表明 VO2L 和 VO2B 与 VO2M 的一致性较差（偏差，-58；95%置信区间[CI]，-258 至 48）和偏差，38；95%CI，-91 至 167）。VO2D 的一致性范围较大，表明与 VO2M 的一致性较低（偏差，13；95%CI，-64 至 89）。VO2L 主要将患者错误分类为低心指数，而 VO2D 和 VO2B 将患者错误分类为正常/高心指数。
在 CHD 成人中，评估心内有创血流动力学时，假设的 VO2 将导致显著误差。
