Department of Anesthesia and Intensive Care Medicine, Oslo University Hospital, Oslo, Nydalen, Norway.
Department of Cardiology, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Oslo, Norway.
Hypertens Pregnancy. 2023 Dec;42(1):2245054. doi: 10.1080/10641955.2023.2245054.
To objectively study cardiorespiratory fitness (CRF) and physical activity (PA) and to evaluate limiting factors of exercise intolerance associated with poor CRF after severe pre-eclampsia.
In this single-centre, cross-sectional study, CRF was measured as peak oxygen uptake (VO) during a cardiopulmonary exercise test (CPET) on a treadmill in women 7 years after severe pre-eclampsia. Ninety-six patients and 65 controls were eligible to participate. Cardiac output (CO) was measured by impedance cardiography. PA was measured using accelerometers.
In 62 patients and 35 controls (mean age 40 ± 3 years), the VO (in mL·kg-1·min-1) values were 31.4 ± 7.2 and 39.1 ± 5.4, respectively (p<0.01). In the patients, the COpeak was (9.6 L·min-1), 16% lower compared to controls (p<0.01). Twelve patients (19%) had a cardiac limitation to CPET. Twenty-three (37%) patients and one (3%) control were classed as unfit, with no cardiopulmonary limitations. The patients demonstrated 25% lower PA level (in counts per minute; p<0.01) and 14% more time being sedentary (p<0.01), compared with the controls. Twenty-one patients (34%) compared with four (17%) controls did not meet the World Health Organization's recommendations for PA (p=0.02). Body mass index and PA level accounted for 65% of the variability in VO.
Significantly lower CRF and PA levels were found in patients on long-term follow-up after severe pre-eclampsia. CPET identified cardiovascular limitations in one third of patients. One third appeared unfit, with adiposity and lower PA levels. These findings highlight the need for clinical follow-up and exercise interventions after severe pre-eclampsia.
客观研究心肺功能（CRF）和体力活动（PA），并评估与严重子痫前期后 CRF 较差相关的运动不耐受的限制因素。
在这项单中心、横断面研究中，在严重子痫前期 7 年后，在跑步机上进行心肺运动测试（CPET）时测量女性的峰值摄氧量（VO）来评估 CRF。96 名患者和 65 名对照者符合参与条件。通过阻抗心动图测量心输出量（CO）。使用加速度计测量 PA。
在 62 名患者和 35 名对照者（平均年龄 40±3 岁）中，VO（以 mL·kg-1·min-1 计）值分别为 31.4±7.2 和 39.1±5.4（p<0.01）。在患者中，COpeak 为（9.6 L·min-1），比对照者低 16%（p<0.01）。12 名患者（19%）存在 CPET 的心脏限制。23 名（37%）患者和 1 名（3%）对照者被归类为不适合，无心肺限制。与对照者相比，患者的 PA 水平低 25%（以每分钟计数计；p<0.01），久坐时间多 14%（p<0.01）。21 名患者（34%）与 4 名对照者（17%）未达到世界卫生组织的 PA 建议（p=0.02）。体重指数和 PA 水平解释了 VO 变异性的 65%。
在严重子痫前期长期随访的患者中，发现 CRF 和 PA 水平显著降低。CPET 发现三分之一的患者存在心血管限制。三分之一的患者表现为肥胖和较低的 PA 水平，不适合运动。这些发现强调了在严重子痫前期后需要进行临床随访和运动干预。
