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6 分钟步行试验后早期心率恢复可预测经皮主动脉瓣植入术后患者的临床获益。

Early Heart Rate Recovery after a 6-min Walking Test Predicts Clinical Benefits in Patients after Percutaneous Aortic Valve Implantation.

机构信息

Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, 50-367 Wroclaw, Poland.

Institute of Heart Diseases, University Hospital, 50-556 Wroclaw, Poland.

出版信息

Int J Environ Res Public Health. 2023 Feb 28;20(5):4270. doi: 10.3390/ijerph20054270.

Abstract

BACKGROUND

It was hypothesized that the time-appropriate return to a resting heart rate (HR) after cessation of exercise could be a marker for predicting outcomes in patients with heart failure (HF). We aimed to evaluate the prognostic value of HR recovery in functional improvement among adults with severe aortic stenosis undergoing percutaneous aortic valve implantation (TAVI).

METHODS

We performed a 6 min walk test (6MWT) in 93 individuals before TAVI and 3 months after the procedure. The change in walking distance was calculated. During the pre-TAVI 6MWT, we analyzed the differences between baseline HR, HR at the end of the test, and HR at the 1st, 2nd, and 3rd minute of recovery.

RESULTS

After 3 months, 6MWT distances improved by 39 ± 63 m and reached a total of 322 ± 117 m. Multiple linear regression proved the differences between HR after 2 min of recovery and baseline HR in pre-TAVI after a 6MWT was the only significant predictor of waking distance improvement during follow-up.

CONCLUSIONS

Our study suggests that analysis of HR recovery after a 6MWT may be a helpful and easy parameter to assess improvements in exercise capacity after TAVI. This simple method can help to identify patients in whom no significant benefit in functional improvement can be expected despite successful valve implantation.

摘要

背景

据推测,运动停止后适当的心率(HR)恢复时间可以作为预测心力衰竭(HF)患者结局的标志物。我们旨在评估 HR 恢复在经皮主动脉瓣植入术(TAVI)治疗严重主动脉瓣狭窄成人患者功能改善中的预后价值。

方法

我们对 93 名患者在 TAVI 前和术后 3 个月进行了 6 分钟步行试验(6MWT)。计算行走距离的变化。在 TAVI 前的 6MWT 中,我们分析了静息 HR、试验结束时的 HR 以及恢复第 1、2 和 3 分钟时的 HR 之间的差异。

结果

3 个月后,6MWT 距离增加了 39±63m,达到 322±117m。多元线性回归证明,在 TAVI 前 6MWT 后 2 分钟的 HR 与静息 HR 之间的差异是随访期间行走距离改善的唯一显著预测因子。

结论

我们的研究表明,分析 6MWT 后 HR 恢复可能是评估 TAVI 后运动能力改善的一种有用且简单的参数。这种简单的方法可以帮助识别尽管瓣膜植入成功但功能改善无明显获益的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad76/10002365/c745e01e221b/ijerph-20-04270-g001.jpg

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