Ohara Kazumasa, Imamura Teruhiko, Ihori Hiroyuki, Chatani Kenichi, Nonomura Makoto, Kameyama Tomoki, Inoue Hiroshi
Internal Medicine, Saiseikai Toyama Hospital, Toyama 931-8533, Japan.
The Second Department of Internal Medicine, University of Toyama, Toyama 930-0194, Japan.
J Clin Med. 2022 Feb 18;11(4):1066. doi: 10.3390/jcm11041066.
The association between right ventricular function and exercise capacity in patients with chronic heart failure remains uncertain. Several studies very recently mentioned the association between right ventricular reserve and exercise capacity, whereas the implication of tricuspid annular plane systolic excursion (TAPSE) remains uninvestigated. We aimed to assess the impact of TAPSE on exercise capacity in cardiac rehabilitation candidates.
Data from patients with chronic heart failure who received cardiopulmonary exercise tests and transthoracic echocardiography prior to cardiac rehabilitation were retrospectively collected, and their association was investigated.
A total of 169 patients with chronic heart failure (70.3 ± 11.7 years old, 74.6% men) were included. Tertiled tricuspid annular plane systolic excursion significantly stratified anaerobic threshold (10.2 ± 2.2, 11.4 ± 2.2, and 12.2 ± 2.8 mm; < 0.01) and peak oxygen consumption (15.9 ± 4.5, 18.3 ± 5.3, and 19.8 ± 5.6 mm; < 0.01). In the multivariate logistic regression analyses, TAPSE was an independent factor associated with anaerobic threshold and peak oxygen consumption ( < 0.05 for both).
Right ventricular impairment was associated with reduced exercise capacity in patients with chronic heart failure. Such knowledge would be useful to estimate patients' exercise capacity and prescribe cardiac rehabilitation. Its longitudinal association and clinical implication need further studies.
慢性心力衰竭患者右心室功能与运动能力之间的关联仍不明确。最近的几项研究提到了右心室储备与运动能力之间的关联，而三尖瓣环平面收缩期位移（TAPSE）的意义仍未得到研究。我们旨在评估TAPSE对心脏康复候选患者运动能力的影响。
回顾性收集慢性心力衰竭患者在心脏康复前接受心肺运动试验和经胸超声心动图检查的数据，并对它们之间的关联进行研究。
共纳入169例慢性心力衰竭患者（年龄70.3±11.7岁，男性占74.6%）。三分位的三尖瓣环平面收缩期位移显著分层了无氧阈（分别为10.2±2.2、11.4±2.2和12.2±2.8mm；<0.01）和最大摄氧量（分别为15.9±4.5、18.3±5.3和19.8±5.6mm；<0.01）。在多因素逻辑回归分析中，TAPSE是与无氧阈和最大摄氧量相关的独立因素（两者均<0.05）。
右心室功能障碍与慢性心力衰竭患者运动能力下降有关。这些知识对于评估患者的运动能力和制定心脏康复方案很有用。其纵向关联和临床意义需要进一步研究。
