Keen Carol, Smith Ian, Hashmi-Greenwood Molly, Sage Karen, Kiely David G
Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Faculty of Health and Education, Manchester Metropolitan University, Manchester, UK.
ERJ Open Res. 2023 Jan 23;9(1). doi: 10.1183/23120541.00295-2022. eCollection 2023 Jan.
Multiparameter risk assessment is recommended to aid treatment decisions in patients with pulmonary arterial hypertension. The 1-min sit-to-stand test (1MSTS) has been validated for use in other respiratory illnesses. The aim of this study was to evaluate its safety in the hospital setting and potential utility in remote assessment in patients with pulmonary hypertension.
In a prospective cohort study design patients performed the 1MSTS and incremental shuttle walk test (ISWT) on the same day. The primary aim of the study was to assess safety signals and correlations with other metrics used in risk assessment.
60 patients with pulmonary arterial hypertension and 15 with chronic thromboembolic pulmonary hypertension were enrolled. No adverse events were recorded. Post-test change in physiological parameters was lower for the 1MSTS than for the ISWT in heart rate (mean±sd change +9.4±8.0 +38.3±25.9 beats per min, p<0.001), oxygen saturation (-3.8±4.0% -8.9±7.3%, p<0.01) and systolic blood pressure (+10.1±10.5 +17.7±19 mmHg, p<0.001). There were significant correlations between the 1MSTS and ISWT (r=0.702, p<0.01), World Health Organization functional class (r= -0.449, p<0.01), emPHAsis-10 (-0.436, p<0.001) and N-terminal pro-b-type natriuretic peptide (r= -0.270, p=0.022). 97% of patients were willing to perform the test at home.
This study has demonstrated the safety, sub-maximal characteristics of the 1MSTS in pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension in the hospital setting, its positive correlation with the ISWT and potential role in remote risk assessment. Further evaluation of this exercise test is now warranted.
推荐进行多参数风险评估以辅助肺动脉高压患者的治疗决策。1分钟坐立试验（1MSTS）已在其他呼吸系统疾病中得到验证。本研究的目的是评估其在医院环境中的安全性以及在肺动脉高压患者远程评估中的潜在效用。
在一项前瞻性队列研究设计中，患者在同一天进行1MSTS和递增式往返步行试验（ISWT）。该研究的主要目的是评估安全信号以及与风险评估中使用的其他指标的相关性。
纳入了60例肺动脉高压患者和15例慢性血栓栓塞性肺动脉高压患者。未记录到不良事件。1MSTS后生理参数的变化在心率（平均±标准差变化 +9.4±8.0对+38.3±25.9次/分钟，p<0.001）、血氧饱和度（-3.8±4.0%对-8.9±7.3%，p<0.01）和收缩压（+10.1±10.5对+17.7±19 mmHg，p<0.001）方面低于ISWT。1MSTS与ISWT之间存在显著相关性（r=0.702，p<0.01）、世界卫生组织功能分级（r=-0.449，p<0.01）、emPHAsis-10（-0.436，p<0.001）和N末端前体B型利钠肽（r=-0.270，p=0.022）。97%的患者愿意在家中进行该测试。
本研究证明了1MSTS在医院环境中对肺动脉高压或慢性血栓栓塞性肺动脉高压患者的安全性、次最大运动特征、与ISWT的正相关性以及在远程风险评估中的潜在作用。现在有必要对这项运动试验进行进一步评估。
