Doctorate Programme of Health Sciences, Universidade Da Coruña, A Coruña, Spain.
Department of Cardiology, Complexo Hospitalario Universitario A Coruña, Instituto Investigación Biomedica A Coruña, A Coruña, Spain.
ESC Heart Fail. 2021 Jun;8(3):2002-2008. doi: 10.1002/ehf2.13275. Epub 2021 Mar 27.
Maximum oxygen uptake (VO ) is an essential parameter to assess functional capacity of patients with heart failure (HF). We aimed to identify clinical factors that determine its value, as they have not been well characterized yet.
We conducted a retrospective, observational, single-centre study of 362 consecutive patients with HF who underwent cardiopulmonary exercise testing (CPET) as part of standard clinical assessment since 2009-2019. CPET was performed on treadmill, according to Bruce's protocol (n = 360) or Naughton's protocol (n = 2). We performed multivariable linear regression analyses in order to identify independent clinical predictors associated with peak VO .
Mean age of study patients was 57.3 ± 10.9 years, mean left ventricular ejection fraction was 32.8 ± 14.2%, and mean VO was 19.8 ± 5.2 mL/kg/min. Eighty-nine (24.6%) patients were women, and 114 (31.5%) had ischaemic heart disease. Multivariable linear regression analysis identified six independent clinical predictors of VO , including NYHA class (B coefficient = -2.585; P < 0.001), age (B coefficient per 1 year = -0.104; P < 0.001), tricuspid annulus plane systolic excursion (B coefficient per 1 mm = +0.209; P < 0.001), body mass index (B coefficient per 1 kg/m = -0.172; P = 0.002), haemoglobin (B coefficient per 1 g/dL = +0.418; P = 0.007) and NT-proBNP (B coefficient per 1000 pg/mL = -0.142; P = 0.019).
The severity of HF (NYHA class, NT-proBNP) as well as age, body composition and haemoglobin levels influence significantly exercise capacity. In patients with HF, the right ventricular systolic function is of greater importance for the physical capacity than the left ventricular systolic function.
最大摄氧量（VO ）是评估心力衰竭（HF）患者功能能力的重要参数。我们旨在确定决定其值的临床因素，因为它们尚未得到很好的描述。
我们进行了一项回顾性、观察性、单中心研究，纳入了 2009 年至 2019 年期间因标准临床评估而接受心肺运动测试（CPET）的 362 例连续 HF 患者。CPET 按照布鲁斯方案（n=360）或诺顿方案（n=2）在跑步机上进行。我们进行了多变量线性回归分析，以确定与峰值 VO 相关的独立临床预测因子。
研究患者的平均年龄为 57.3±10.9 岁，平均左心室射血分数为 32.8±14.2%，平均 VO 为 19.8±5.2 mL/kg/min。89 例（24.6%）为女性，114 例（31.5%）患有缺血性心脏病。多变量线性回归分析确定了 VO 的六个独立临床预测因子，包括 NYHA 分级（B 系数=-2.585；P<0.001）、年龄（每年增加 1 岁的 B 系数=-0.104；P<0.001）、三尖瓣环平面收缩期位移（每增加 1mm 的 B 系数=+0.209；P<0.001）、体重指数（每增加 1kg/m 2 的 B 系数=-0.172；P=0.002）、血红蛋白（每增加 1g/dL 的 B 系数=+0.418；P=0.007）和 NT-proBNP（每增加 1000pg/mL 的 B 系数=-0.142；P=0.019）。
HF 的严重程度（NYHA 分级、NT-proBNP）以及年龄、身体成分和血红蛋白水平显著影响运动能力。在 HF 患者中，右心室收缩功能对体力的重要性大于左心室收缩功能。
