Wang Zheng, Yan Jianhua, Meng Shu, Li Jiajia, Yu Yi, Zhang Tingting, Tsang Raymond C C, El-Ansary Doa, Han Jia, Jones Alice Y M
Department of Sport Rehabilitation, School of Kinesiology, Shanghai University of Sport, Shanghai, China.
Department of Cardiology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Cardiovasc Med. 2022 Aug 25;9:841453. doi: 10.3389/fcvm.2022.841453. eCollection 2022.
Sit-To-Stand (STS) tests are reported as feasible alternatives for the assessment of functional fitness but the reliability of these tests in people with coronary artery disease (CAD) has not been reported. This study explored the test-retest reliability, convergent and known-groups validity of the five times, 30-sec and 1-min sit-to-stand test (FTSTS test, 30-s STS test and 1-min STS test respectively) in patients with CAD. The feasibility of applying these tests to distinguish the level of risk for cardiovascular events in CAD patients was also investigated.
Patients with stable CAD performed a 6MWT and 3 STS tests in random order on the same day. Receiver operating characteristic (ROC) curve analyses were conducted using STS test data to differentiate patients with low or high risk of cardiovascular events based on the risk level determined by distance covered in the 6MWT as > or ≤ 419 m. Thirty patients repeated the 3 STS tests on the following day.
112 subjects with diagnoses of atherosclerosis or post-percutaneous coronary intervention, or post-acute myocardial infarction (post-AMI) participated in the validity analysis. All 3 STS tests demonstrated moderate and significant correlation with the 6MWT (coefficient values for the FTSTS, 30-s STS and 1-min STS tests were-0.53, 0.57 and 0.55 respectively). Correlations between left ventricular ejection fraction (LVEF) and all STS tests and between 6MWT and LVEF were only weak ( ranged from 0.27 to 0.31). Subgroup analysis showed participants in the post-AMI group performed worse in all tests compared to non-myocardial infarction (non-MI) group. The area under the curve (AUC) was 0.80 for FTSTS (sensitivity: 75.0%, specificity: 73.8%, optimal cut-off: >11.7 sec), and the AUC, sensitivity, specificity and optimal cut-off for 30-s STS and 1-min STS test were 0.83, 75.0%, 76.2%, ≤ 12 repetitions and 0.80, 71.4%, 73.8%, ≤ 23 repetitions respectively. The intraclass correlation coefficients (ICC) for repeated measurements of the FTSTS, 30-s STS and 1-min STS tests were 0.96, 0.95 and 0.96 respectively, with the minimal detectable change (MDC) computed to be 1.1 sec 1.8 repetitions and 3.9 repetitions respectively.
All STS tests demonstrated good test-retest reliability, convergent and known-groups validity. STS tests may discriminate low from high levels of risk for a cardiovascular event in patients with CAD.
坐立试验（STS）被报道为评估功能适应性的可行替代方法，但这些试验在冠状动脉疾病（CAD）患者中的可靠性尚未见报道。本研究探讨了5次、30秒和1分钟坐立试验（分别为FTSTS试验、30秒STS试验和1分钟STS试验）在CAD患者中的重测信度、收敛效度和已知组效度。还研究了应用这些试验区分CAD患者心血管事件风险水平的可行性。
稳定性CAD患者在同一天以随机顺序进行6分钟步行试验（6MWT）和3次STS试验。使用STS试验数据进行受试者工作特征（ROC）曲线分析，以根据6MWT中行走距离确定的风险水平（>或≤419米）区分心血管事件低风险或高风险患者。30名患者在第二天重复进行3次STS试验。
112名诊断为动脉粥样硬化或经皮冠状动脉介入治疗后或急性心肌梗死（AMI）后的受试者参与了效度分析。所有3次STS试验均与6MWT显示出中度且显著的相关性（FTSTS试验、30秒STS试验和1分钟STS试验的系数值分别为-0.53、0.57和0.55）。左心室射血分数（LVEF）与所有STS试验之间以及6MWT与LVEF之间的相关性仅较弱（范围为0.27至0.31）。亚组分析显示，与非心肌梗死（非MI）组相比，AMI后组的所有试验参与者表现更差。FTSTS试验的曲线下面积（AUC）为0.80（敏感性：75.0%，特异性：73.8%，最佳截断值：>11.7秒），30秒STS试验和1分钟STS试验的AUC、敏感性、特异性和最佳截断值分别为0.83、75.0%、76.2%、≤12次重复和0.80、71.4%、73.8%、≤23次重复。FTSTS试验、30秒STS试验和1分钟STS试验重复测量的组内相关系数（ICC）分别为0.96、0.95和0.96，计算得出的最小可检测变化（MDC）分别为1.1秒、1.8次重复和3.9次重复。
所有STS试验均显示出良好的重测信度、收敛效度和已知组效度。STS试验可区分CAD患者心血管事件的低风险和高风险水平。
