Steenhorst Jarno J, Hirsch Alexander, van den Berg Linda E M, Kamphuis Lieke S, Merkus Daphne, Boersma Eric, Helbing Willem A
Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Department of Pediatrics, Division of Pediatric Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Clin Physiol Funct Imaging. 2023 Jan;43(1):10-19. doi: 10.1111/cpf.12784. Epub 2022 Oct 6.
Cardiovascular magnetic resonance (CMR) imaging during supine exercise at (sub)maximal oxygen consumption (VO ) offers unique diagnostic insights. However, maximal VO is not achievable in the supine position and standardizing submaximal exercise intensities remains challenging. Using heart rate or workload could be a viable option to translate VO -based submaximal exercise intensities.
To translate submaximal exercise intensities upright cycling exercise (UCE) to supine push-pull exercise (SPPE), by comparing heart rate or workload determined during UCE, with heart rate and workload during SPPE at similar exercise intensities.
Sixteen healthy young adults (20.4 ± 2.2 years; 8 female) underwent cardiopulmonary UCE and SPPE testing [mean ± standard deviation maximal VO : 3.2 ± 0.6 vs. 5 ± 0.3 L min , p < 0.001 and median (interquartile range) of the maximum workload: 310 (244, 361) vs. 98 (98, 100), p < 0.001, respectively]. Heart rate at 40% and 60% of maximal VO , as determined by UCE, showed low bias (-3 and 0 bpm, respectively) and wide limits of agreement (±26 and ±28 bpm, respectively), in Bland-Altman analysis. VO /Workload relation was exponential and less efficient during SPPE compared to UCE. Generalized estimated equation analysis predicted model-based mean workload during SPPE, with acceptable 95% confidence interval.
Heart rate during UCE at submaximal exercise intensities can reasonably well be used to for SPPE in healthy subjects. Using workload, an ergometer specific, model-based mean can be used to determine exercise intensities during SPPE. Individual variations in response to posture and movement change are high. During clinical interpretation of exercise CMR, individual exercise intensity has to be considered.
在仰卧位运动达到（次）最大耗氧量（VO₂）时进行心血管磁共振（CMR）成像可提供独特的诊断见解。然而，在仰卧位无法达到最大VO₂，且标准化次最大运动强度仍具有挑战性。使用心率或工作量可能是转换基于VO₂的次最大运动强度的可行选择。
通过比较在相似运动强度下，直立骑自行车运动（UCE）期间测定的心率或工作量与仰卧位推拉运动（SPPE）期间的心率和工作量，将次最大运动强度从UCE转换到SPPE。
16名健康年轻成年人（20.4±2.2岁；8名女性）接受了心肺UCE和SPPE测试[平均±标准差最大VO₂：3.2±0.6 vs. 5±0.3 L·min⁻¹，p<0.001；最大工作量的中位数（四分位间距）：310（244，361）vs. 98（98，100），p<0.001]。在布兰德-奥特曼分析中，UCE测定的最大VO₂的40%和60%时的心率显示出低偏差（分别为-3和0次/分钟）和较宽的一致性界限（分别为±26和±28次/分钟）。与UCE相比，SPPE期间VO₂/工作量关系呈指数关系且效率较低。广义估计方程分析预测了基于模型的SPPE期间平均工作量，其95%置信区间可接受。
在健康受试者中，次最大运动强度下UCE期间的心率可合理地用于SPPE。使用工作量时，可使用基于测力计特定模型的平均值来确定SPPE期间的运动强度。对姿势和运动变化的个体反应差异很大。在运动CMR的临床解读中，必须考虑个体运动强度。
