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比较特发性肺纤维化患者固定百分比心率与通气阈。

Comparison of heart rates at fixed percentages and the ventilatory thresholds in patients with interstitial lung disease.

机构信息

Department of Pulmonary Medicine, Medical University of Vienna, Vienna, Austria.

Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria.

出版信息

Scand J Med Sci Sports. 2022 Apr;32(4):754-764. doi: 10.1111/sms.14117. Epub 2021 Dec 26.

Abstract

Heart rate (HR) responses to maximal exercise are commonly used for the prescription of training intensities in pulmonary rehabilitation. Those intensities are usually based on fixed percentages of peak HR (HRpeak), heart rate reserve (HRR), or peak work load (Wpeak), and rarely on HRs at the individual ventilatory thresholds (VT1 and VT2) derived from cardiopulmonary exercise testing (CPET). For patients suffering from interstitial lung disease (ILD), data on cardiorespiratory responses to CPET are scarce. Thus, the aim of this study was to record cardiorespiratory responses to CPET and to compare fixed HR percentages with HRs at VT1 and VT2 in ILD patients. A total of 120 subjects, 80 ILD patients and 40 healthy controls, underwent a symptom-limited CPET. From the ILD patient, 32 suffered from idiopathic pulmonary fibrosis (IPF), 37 from connective tissue disease (CTD), and 11 from sarcoidosis. HRs at fixed percentages, that is, at 70%HRpeak, at 70%Wpeak, and at 60%HRR were significantly lower in the ILD patients compared with the control group (p-values: 0.001, 0.044, and 0.011). Large percentages of HR values at 70%Wpeak and 60%HRR ranged between the HRs at VT1 and VT2 in ILD subgroups and controls as well. HRs at 70%HRpeak were lower than HRs at VT1 in 66% of the IPF patients, 54% of the CTD patients, and 55% of patients with sarcoidosis compared with 18% in the control group. Our findings demonstrate a considerable scattering of fixed HR percentages compared with HRs at the individual VTs derived from CPET in ILD patients. These findings may provide valuable information for the prescription of exercise intensity in pulmonary rehabilitation of ILD patients.

摘要

心率(HR)对最大运动的反应通常用于肺康复中训练强度的处方。这些强度通常基于峰值 HR(HRpeak)、心率储备(HRR)或峰值工作量(Wpeak)的固定百分比,很少基于心肺运动测试(CPET)得出的个体通气阈值(VT1 和 VT2)的 HR。对于患有间质性肺疾病(ILD)的患者,CPET 时心肺反应的数据很少。因此,本研究的目的是记录 CPET 时的心肺反应,并比较ILD 患者的固定 HR 百分比与 VT1 和 VT2 时的 HR。共有 120 名受试者,80 名ILD 患者和 40 名健康对照者接受了症状限制的 CPET。ILD 患者中,32 名患有特发性肺纤维化(IPF),37 名患有结缔组织疾病(CTD),11 名患有结节病。ILD 患者的固定百分比(即 HRpeak 的 70%、Wpeak 的 70%和 HRR 的 60%)的 HR 明显低于对照组(p 值:0.001、0.044 和 0.011)。ILD 亚组和对照组的 HR 值 70%Wpeak 和 60%HRR 的百分比也在 VT1 和 VT2 之间的 HR 值范围内。在 IPF 患者中,66%、CTD 患者中 54%和结节病患者中 55%的 HRs 70%HRpeak 低于 VT1 的 HR,而对照组中只有 18%。我们的发现表明,ILD 患者与 CPET 得出的个体 VT 相比,固定 HR 百分比存在相当大的分散。这些发现可能为ILD 患者的肺康复运动强度的处方提供有价值的信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f043/9304263/c6c400058e51/SMS-32-754-g001.jpg

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