Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom.
School of Physical and Occupational Therapy, McGill University, Montréal, Quebec, Canada.
Am J Respir Crit Care Med. 2023 May 1;207(9):1227-1236. doi: 10.1164/rccm.202205-0858OC.
Premature birth is an independent predictor of long-term cardiovascular risk. Individuals affected are reported to have a lower rate of [Formula: see text]o at peak exercise intensity ([Formula: see text]o) and at the ventilatory anaerobic threshold ([Formula: see text]o), but little is known about their response to exercise training. The primary objective was to determine whether the [Formula: see text]o response to exercise training differed between preterm-born and term-born individuals; the secondary objective was to quantify group differences in [Formula: see text]o response. Fifty-two preterm-born and 151 term-born participants were randomly assigned (1:1) to 16 weeks of aerobic exercise training ( = 102) or a control group ( = 101). Cardiopulmonary exercise tests were conducted before and after the intervention to measure [Formula: see text]o and the [Formula: see text]o. A prespecified subgroup analysis was conducted by fitting an interaction term for preterm and term birth histories and exercise group allocation. For term-born participants, [Formula: see text]o increased by 3.1 ml/kg/min (95% confidence interval [CI], 1.7 to 4.4), and the [Formula: see text]o increased by 2.3 ml/kg/min (95% CI, 0.7 to 3.8) in the intervention group versus controls. For preterm-born participants, [Formula: see text]o increased by 1.8 ml/kg/min (95% CI, -0.4 to 3.9), and the [Formula: see text]o increased by 4.6 ml/kg/min (95% CI, 2.1 to 7.0) in the intervention group versus controls. No significant interaction was observed with birth history for [Formula: see text]o ( = 0.32) or the [Formula: see text]o ( = 0.12). The training intervention led to significant improvements in [Formula: see text]o and [Formula: see text]o, with no evidence of a statistically different response based on birth history. Clinical trial registered with www.clinicaltrials.gov (NCT02723552).
早产是长期心血管风险的独立预测因子。据报道,受影响的个体在最大运动强度时的摄氧量峰值 ([Formula: see text]o) 和通气无氧阈值 ([Formula: see text]o) 较低,但对于他们对运动训练的反应知之甚少。主要目的是确定早产儿和足月出生的个体的运动训练后摄氧量反应是否存在差异;次要目的是量化摄氧量反应的组间差异。52 名早产儿和 151 名足月出生的参与者被随机分配(1:1)接受 16 周的有氧运动训练( = 102)或对照组( = 101)。干预前后进行心肺运动测试,以测量摄氧量和无氧阈。通过拟合早产和足月出生史以及运动组分配的交互项进行了预设的亚组分析。对于足月出生的参与者,干预组的摄氧量增加了 3.1ml/kg/min(95%置信区间 [CI],1.7 至 4.4),而对照组则增加了 2.3ml/kg/min(95%CI,0.7 至 3.8)。对于早产儿,摄氧量增加了 1.8ml/kg/min(95%CI,-0.4 至 3.9),干预组比对照组增加了 4.6ml/kg/min(95%CI,2.1 至 7.0)。出生史对摄氧量( = 0.32)或无氧阈( = 0.12)没有观察到显著的交互作用。该训练干预导致摄氧量和无氧阈显著提高,没有证据表明基于出生史的反应存在统计学差异。该临床试验在 www.clinicaltrials.gov(NCT02723552)注册。