Poty Antoine, Krim Florent, Lopes Philippe, Garaud Yves, Leprêtre Pierre-Marie
Exercise Physiology and Rehabilitation Laboratory, Picardie Jules Verne University, Amiens, France.
Fundation Léopold Bellan, Chateau d'Ollencourt, Unit of Cardiac Rehabilitation, Tracy-le-Mont, France.
Front Cardiovasc Med. 2022 May 19;9:811458. doi: 10.3389/fcvm.2022.811458. eCollection 2022.
Preoperative peak oxygen uptake ( O ) and ventilatory efficiency ( / COslope) are related to the vital prognosis after cardiac transplantation (HTx). The objective of our study was to evaluate the effects of exercise-based cardiac rehabilitation (ECR) program on the preoperative exercise capacity of a HTx candidate. A male patient, aged 50-55 years, with chronic heart failure was placed on the HTx list and performed 12 weeks of intensive ECR (5 sessions-a-week). Our results showed that the cardiac index continuously increased between the onset and the end of ECR (1.40 vs. 2.53 L.min.m). The first 20 sessions of ECR induced a O increase (15.0 vs. 19.3 ml.min.kg, corresponding to 42.0 and 53.0% of its maximal predicted values, respectively). The peak O plateaued between the 20th and the 40th ECR session (19.3 vs. 19.4 ml.min.kg) then progressively increased until the 60th ECR session to reach 25.7 ml.min.kg, i.e., 71.0% of the maximal predicted values. The slope of / CO showed a biphasic response during the ECR program, with an increase between the onset and the 20th ECR session (58.02 vs. 70.48) and a decrease between the 20th and the 40th ECR session (70.48 vs. 40.94) to reach its minimal value at the 60th ECR session (31.97). After the first 40 sessions of the ECR program, the Seattle Heart Failure Model score predicted median survival time was estimated at 7.2 years. In conclusion, the improvement in exercise capacity and cardiorespiratory function following the ECR helped delay the heart transplant surgery in our patient awaiting heart transplantation.
术前峰值摄氧量（VO₂）和通气效率（VE/CO₂斜率）与心脏移植（HTx）后的重要预后相关。我们研究的目的是评估基于运动的心脏康复（ECR）计划对HTx候选者术前运动能力的影响。一名50 - 55岁的男性慢性心力衰竭患者被列入HTx名单，并进行了为期12周的强化ECR（每周5次）。我们的结果显示，在ECR开始至结束期间，心脏指数持续增加（1.40对2.53 L·min·m²）。ECR的前20次训练使VO₂增加（15.0对19.3 ml·min·kg，分别相当于其最大预测值的42.0%和53.0%）。VO₂峰值在第20次至第40次ECR训练期间保持稳定（19.3对19.4 ml·min·kg），然后逐渐增加，直至第60次ECR训练时达到25.7 ml·min·kg，即最大预测值的71.0%。VE/CO₂斜率在ECR计划期间呈现双相反应，在开始至第20次ECR训练期间增加（58.02对70.48），在第20次至第40次ECR训练期间下降（70.48对40.94），并在第60次ECR训练时达到最小值（31.97）。在ECR计划的前40次训练后，西雅图心力衰竭模型评分预测的中位生存时间估计为7.2年。总之，ECR后运动能力和心肺功能的改善有助于延迟我们这位等待心脏移植患者的心脏移植手术。
