Luo Q, Shen Y Q, Zhuang B, Shen T, Liu X L, Li G H, Jiang Y M, Li D J, Zhan M Y, Song H M, Wang L M
Department of Cardiac Rehabilitation, Tongji Hospital Affiliated to Tongji University, School of Medicine, Tongji University, Shanghai 200092, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2022 Aug 24;50(8):785-790. doi: 10.3760/cma.j.cn112148-20220429-00329.
To investigate the correlation between heart rate index (HRI), systolic blood pressure(SBP) peak-to-SBPrest ratio (SBPR) and peak oxygen consumption (peakVO) in patients with chronic heart failure (CHF), and discuss the possibility of using HRI and SBPR collected during exercise to assess the exercise tolerance of CHF patients in the absence of gas analysis. In this cross-sectional study, a total of 547 patients with CHF who underwent cardiopulmonary exercise test(CPET) in Tongji Hospital Heart Rehabilitation Center Affiliated to Tongji University from March 2007 to December 2018 were collected retrospectively, focusing on their clinical data including age, gender, type of heart failure,BMI as well as data collected during their CPETs, such as peakVO, HRI and SBPR. Spearman univariate correlation analysis was used for statistical analysis, to unveil the correlations between peakVO and those parameters, and multiple linear regression analysis was also conducted. A total of 547 CHF patients conducting CPET were included in this research, of which 447 were male, at age of 63(56, 69). Univariate analysis indicates that HRI, SBPR and peakVO showed significant positive correlation (=0.323, 0.263, respectively, all <0.001); Age and peak VO showed significant negative correlation(=-0.207, <0.001); Male patients showed peakVO higher than female(=-0.229, <0.001); PeakVO of heart failure with reduced ejection fraction(HFrEF) was lower than heart failure with mid-range ejection fraction(HFmrEF)and heart failure with preserved ejection fraction(HFpEF) (=0.181, <0.001). Body mass index (BMI) had no significant correlation with peakVO (>0.05). Multivariate linear regression analysis showed that the HRI, SBPR were positively correlated with peakVO(=7.68, 5.08, respectively, all <0.05), while age and BMI showed negative correlation with peakVO(=-5.43, -0.31, respectively, all <0.05). PeakVO of male was higher than female(=-6.03, <0.05), and peakVO of HFrEF was lower than those of HFmrEF and HFpEF(=3.17, 4.48, respectively, all <0.05). A linear equation (=33.52, adjusted =0.29) could be constructed: peakVO=10.65(male) or 8.53(female)+4.26HRI+3.31SBPR-0.07age-0.13BMI+0(HFrEF) or 1.05 (HFmrEF) or 1.62(HFpEF). HRI and SBPR are positively correlated with peakVO. In the absence of gas analysis, it is possible to apply HRI and SBPR during exercise to predict exercise tolerance in patients with CHF.
探讨慢性心力衰竭（CHF）患者心率指数（HRI）、收缩压峰值与静息收缩压比值（SBPR）和峰值耗氧量（peakVO）之间的相关性，并讨论在无气体分析的情况下，利用运动过程中采集的HRI和SBPR评估CHF患者运动耐力的可能性。在这项横断面研究中，回顾性收集了2007年3月至2018年12月在同济大学附属同济医院心脏康复中心接受心肺运动试验（CPET）的547例CHF患者，重点关注其临床资料，包括年龄、性别、心力衰竭类型、BMI，以及CPET期间采集的数据，如peakVO、HRI和SBPR。采用Spearman单因素相关性分析进行统计分析，以揭示peakVO与这些参数之间的相关性，并进行多元线性回归分析。本研究共纳入547例进行CPET的CHF患者，其中男性447例，年龄63（56，69）岁。单因素分析表明，HRI、SBPR与peakVO呈显著正相关（分别为=0.323、0.263，均<0.001）；年龄与peakVO呈显著负相关（=-0.207，<0.001）；男性患者的peakVO高于女性（=-0.229，<0.001）；射血分数降低的心力衰竭（HFrEF）患者的peakVO低于射血分数中等范围的心力衰竭（HFmrEF）和射血分数保留的心力衰竭（HFpEF）患者（=0.181，<0.001）。体重指数（BMI）与peakVO无显著相关性（>0.05）。多元线性回归分析表明，HRI、SBPR与peakVO呈正相关（分别为=7.68、5.08，均<0.05），而年龄和BMI与peakVO呈负相关（分别为=-5.43、-0.31，均<0.05）。男性的peakVO高于女性（=-6.03，<0.05），HFrEF患者的peakVO低于HFmrEF和HFpEF患者（分别为=3.17、4.48，均<0.05）。可构建线性方程（=33.52，调整后=0.29）：peakVO=10.65（男性）或8.53（女性）+4.26HRI+3.31SBPR-0.07年龄-0.13BMI+0（HFrEF）或1.05（HFmrEF）或1.62（HFpEF）。HRI和SBPR与peakVO呈正相关。在无气体分析的情况下，运动期间应用HRI和SBPR有可能预测CHF患者的运动耐力。
