Kurpaska Małgorzata, Krzesiński Paweł, Gielerak Grzegorz, Gołębiewska Karina, Piotrowicz Katarzyna
Department of Cardiology and Internal Medicine, Military Institute of Medicine, ul. Szaserów 128, 04-141, Warsaw, Poland.
BMC Sports Sci Med Rehabil. 2022 Jul 17;14(1):134. doi: 10.1186/s13102-022-00527-w.
Patients with coronary artery disease (CAD) are characterized by different levels of physical capacity, which depends not only on the anatomical advancement of atherosclerosis, but also on the individual cardiovascular hemodynamic response to exercise. The aim of this study was evaluating the relationship between parameters of exercise capacity assessed via cardiopulmonary exercise testing (CPET) and impedance cardiography (ICG) hemodynamics in patients with CAD.
Exercise capacity was assessed in 54 patients with CAD (41 men, aged 59.5 ± 8.6 years) within 6 weeks after revascularization by means of oxygen uptake (VO), assessed via CPET, and hemodynamic parameters [heart rate (HR), stroke volume, cardiac output (CO), left cardiac work index (LCWi)], measured by ICG. Correlations between these parameters at anaerobic threshold (AT) and at the peak of exercise as well as their changes (Δpeak-rest, Δpeak-AT) were evaluated.
A large proportion of patients exhibited reduced exercise capacity, with 63% not reaching 80% of predicted peak VO. Clinically relevant correlations were noted between the absolute peak values of VO versus HR, VO versus CO, and VO versus LCWi (R = 0.45, p = 0.0005; R = 0.33, p = 0.015; and R = 0.40, p = 0.003, respectively). There was no correlation between AT VO and hemodynamic parameters at the AT time point. Furthermore ΔVO (peak-AT) correlated with ΔHR (peak-AT), ΔCO (peak-AT) and ΔLCWi (peak-AT) (R = 0.52, p < 0.0001, R = 0.49, p = 0.0001; and R = 0.49, p = 0.0001, respectively). ΔVO (peak-rest) correlated with ΔHR (peak-rest), ΔCO (peak-rest), and ΔLCWi (peak-rest) (R = 0.47, p < 0.0001; R = 0.41, p = 0.002; and R = 0.43, p = 0.001, respectively).
ICG is a reliable method of assessing the cardiovascular response to exercise in patients with CAD. Some ICG parameters show definite correlations with parameters of cardiovascular capacity of proven clinical utility, such as peak VO.
冠状动脉疾病（CAD）患者具有不同水平的身体能力，这不仅取决于动脉粥样硬化的解剖进展，还取决于个体对运动的心血管血液动力学反应。本研究的目的是评估通过心肺运动试验（CPET）评估的运动能力参数与CAD患者的阻抗心动图（ICG）血液动力学之间的关系。
在54例CAD患者（41例男性，年龄59.5±8.6岁）血运重建后6周内，通过CPET评估的摄氧量（VO）和ICG测量的血液动力学参数[心率（HR）、每搏输出量、心输出量（CO）、左心作功指数（LCWi）]来评估运动能力。评估了这些参数在无氧阈值（AT）和运动峰值时的相关性以及它们的变化（Δ峰值-静息、Δ峰值-AT）。
很大一部分患者运动能力下降，63%的患者未达到预测峰值VO的80%。VO的绝对峰值与HR、VO与CO、VO与LCWi之间存在临床相关的相关性（分别为R = 0.45，p = 0.0005；R = 0.33，p = 0.015；R = 0.40，p = 0.003）。在AT时间点，AT VO与血液动力学参数之间无相关性。此外，ΔVO（峰值-AT）与ΔHR（峰值-AT）、ΔCO（峰值-AT）和ΔLCWi（峰值-AT）相关（分别为R = 0.52，p < 0.0001；R = 0.49，p = 0.0001；R = 0.49，p = 0.0001）。ΔVO（峰值-静息）与ΔHR（峰值-静息）、ΔCO（峰值-静息）和ΔLCWi（峰值-静息）相关（分别为R = 0.47，p < 0.0001；R = 0.41，p = 0.002；R = 0.43，p = 0.001）。
ICG是评估CAD患者运动心血管反应的可靠方法。一些ICG参数与已证实具有临床效用的心血管能力参数（如峰值VO）显示出明确的相关性。
