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心肺运动试验(CPET)指导的心脏康复对慢性心力衰竭(CHF)患者心肺功能、运动耐力以及N末端脑钠肽前体(NT-proBNP)和超敏肌钙蛋白T(hscTnT)水平的影响。

The effects of CPET-guided cardiac rehabilitation on the cardiopulmonary function, the exercise endurance, and the NT-proBNP and hscTnT levels in CHF patients.

作者信息

Wang Yuanyuan, Cao Jingli, Kong Xiangwen, Wang Shangwei, Meng Lingjie, Wang Yuan

机构信息

Cardiac Rehabilitation Center, Rizhao International Heart Hospital Rizhao, Shandong Province, China.

Department of Coronary Heart Disease in Intensive Care Unit, Rizhao International Heart Hospital Rizhao, Shandong Province, China.

出版信息

Am J Transl Res. 2021 Jun 15;13(6):7104-7114. eCollection 2021.

Abstract

OBJECTIVE

To explore the effects of cardiopulmonary exercise testing (CPET) on the cardiopulmonary function, the exercise endurance, and the NT-proBNP and hscTnT levels in chronic heart failure (CHF) patients.

METHODS

Altogether 98 patients with CHF were randomly divided into a control group and a CPET group, with 49 cases in each group. The control group was administered routine treatment, and the CPET group was administered CPET cardiac rehabilitation training in addition to the routine treatment. Heart and lung function, exercise endurance, and the peripheral blood NTproBNP, hscTnT, and CRP levels were observed. The patients' quality of life, anxiety, and depression were observed using the scale.

RESULTS

After the treatment, the left ventricular end systolic diameters (LVESD) and the left ventricular end diastolic diameters (LVEDD) were significantly decreased, the left ventricular ejection fractions (LVEF), the stroke volumes (SV), and the CI levels were significantly increased, and there were significant differences in these indexes between the CPET group and the control group (all P<0.05). After the treatment, the carbon dioxide ventilation equivalent slope (VE/VCOslop) decreased significantly, the peak oxygen consumption (peakVO) and anaerobic threshold oxygen consumption (VOAT) levels increased significantly, and there were significant differences in these indicators between the CPET group and the control group (all P<0.05). Compared with the control group, the exercise endurance, the maximum oxygen uptake capacity (VOmax), the maximum power, the exhaustion times, and the six-minute walking test (6MWT) levels in the CPET group increased significantly (all P<0.05). After the treatment, the N-terminal precursor brain natriuretic peptide (NTproBNP), the high sensitivity cardiac troponin (hscTnT), and the C-reactive protein (CRP) levels in the two groups were decreased compared with their pre-treatment levels, and there were significant differences in these indexes between the CPET group and the control group (all P<0.05). After the treatment, the Minnesota living with heart failure questionnaire (MLHFQ), the self-rating anxiety scale (SAS), and the self-rating depression scale (SDS) scores in the two groups were significantly lower than they were before the treatment, and there were significant differences in the two scores between the CPET group and the control group (all P<0.05).

CONCLUSION

CPET for patients with CHF helps increase heart and lung function, improves exercise endurance, reduces the NT-proBNP and hscTnT levels, and improves patients' quality of life.

摘要

目的

探讨心肺运动试验(CPET)对慢性心力衰竭(CHF)患者心肺功能、运动耐力及N末端B型利钠肽原(NT-proBNP)和高敏肌钙蛋白T(hscTnT)水平的影响。

方法

将98例CHF患者随机分为对照组和CPET组,每组49例。对照组给予常规治疗,CPET组在常规治疗基础上给予CPET心脏康复训练。观察心肺功能、运动耐力及外周血NT-proBNP、hscTnT和C反应蛋白(CRP)水平。采用量表观察患者的生活质量、焦虑和抑郁情况。

结果

治疗后,左心室收缩末期内径(LVESD)和左心室舒张末期内径(LVEDD)显著降低,左心室射血分数(LVEF)、每搏输出量(SV)和心脏指数(CI)水平显著升高,CPET组与对照组这些指标比较差异有统计学意义(均P<0.05)。治疗后,二氧化碳通气当量斜率(VE/VCOslop)显著降低,峰值摄氧量(peakVO)和无氧阈摄氧量(VOAT)水平显著升高,CPET组与对照组这些指标比较差异有统计学意义(均P<0.05)。与对照组比较,CPET组运动耐力、最大摄氧量(VOmax)、最大功率、疲劳时间和6分钟步行试验(6MWT)水平显著升高(均P<0.05)。治疗后,两组N末端脑钠肽前体(NT-proBNP)、高敏心肌肌钙蛋白(hscTnT)和CRP水平较治疗前降低,CPET组与对照组这些指标比较差异有统计学意义(均P<0.05)。治疗后,两组明尼苏达心力衰竭生活质量问卷(MLHFQ)、焦虑自评量表(SAS)和抑郁自评量表(SDS)评分均显著低于治疗前,CPET组与对照组评分比较差异有统计学意义(均P<0.05)。

结论

对CHF患者进行CPET有助于提高心肺功能,改善运动耐力,降低NT-proBNP和hscTnT水平,提高患者生活质量。

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