Research Unit Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.
Department of Clinical Physiology in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Clin Physiol Funct Imaging. 2023 Nov;43(6):441-452. doi: 10.1111/cpf.12842. Epub 2023 Jun 23.
Interpretation of cardiopulmonary exercise testing (CPET) results requires thorough understanding of test confounders such as anthropometrics, comorbidities and medication. Here, we comprehensively assessed the clinical determinants of cardiorespiratory fitness and its components in a heterogeneous patient sample.
We retrospectively collected medical and CPET data from 2320 patients (48.2% females) referred for cycle ergometry at the University Hospital Leuven, Belgium. We assessed clinical determinants of peak CPET indexes of cardiorespiratory fitness (CRF) and its hemodynamic and ventilatory components using stepwise regression and quantified multivariable-adjusted differences in indexes between cases and references.
Lower peak load and peak O uptake were related to: higher age, female sex, lower body height and weight, and higher heart rate; to the intake of beta blockers, analgesics, thyroid hormone replacement and benzodiazepines; and to diabetes mellitus, chronic kidney disease, non-ST elevation myocardial infarction and atrial fibrillation (p < 0.05 for all). Lower peak load also correlated with obstructive pulmonary diseases. Stepwise regression revealed associations of hemodynamic and ventilatory indexes (including heart rate, O pulse, systolic blood pressure and ventilation at peak exercise and ventilatory efficiency) with age, sex, body composition and aforementioned diseases and medications. Multivariable-adjusted differences in CPET metrics between cases and controls confirmed the associations observed.
We described known and novel associations of CRF components with demographics, anthropometrics, cardiometabolic and pulmonary diseases and medication intake in a large patient sample. The clinical implications of long-term noncardiovascular drug intake for CPET results require further investigation.
心肺运动测试（CPET）结果的解读需要彻底了解测试混杂因素，如人体测量学、合并症和药物。在这里，我们综合评估了异质患者样本中心肺适应能力及其组成部分的临床决定因素。
我们回顾性地收集了来自比利时鲁汶大学医院的 2320 名患者（48.2%为女性）的医学和 CPET 数据。我们使用逐步回归评估了心肺适应能力（CRF）及其血流动力学和通气成分的 CPET 指标的临床决定因素，并量化了病例与参考之间指标的多变量调整差异。
较低的峰值负荷和峰值摄氧量与：较高的年龄、女性、较低的身高和体重以及较高的心率；β受体阻滞剂、镇痛药、甲状腺激素替代和苯二氮䓬类药物的摄入；糖尿病、慢性肾脏病、非 ST 段抬高型心肌梗死和心房颤动（p 值均<0.05）有关。较低的峰值负荷也与阻塞性肺疾病有关。逐步回归显示，血流动力学和通气指数（包括心率、氧脉搏、收缩压和峰值运动时的通气以及通气效率）与年龄、性别、身体成分以及上述疾病和药物有关。病例和对照组之间 CPET 指标的多变量调整差异证实了观察到的关联。
我们描述了在大型患者样本中，CRF 成分与人口统计学、人体测量学、心血管代谢和肺部疾病以及药物摄入的已知和新的关联。长期非心血管药物摄入对 CPET 结果的临床意义需要进一步研究。
