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评估与室性早搏相关的心脏功能障碍的早期指标:心肺功能。

An Early Indicator in Evaluating Cardiac Dysfunction Related to Premature Ventricular Complexes: Cardiorespiratory Capacity.

作者信息

Ma Xiaozhu, Yan Jiangtao, Liu Wanjun

机构信息

Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China.

出版信息

Healthcare (Basel). 2023 Nov 10;11(22):2940. doi: 10.3390/healthcare11222940.

Abstract

Cardiac dysfunction induced by premature ventricular complexes (PVCs) is relatively controversial and challenging to detect in the early stage. In this observational study, we retrospectively analyzed the cardiopulmonary exercise test (CPET) data of 94 patients with frequent premature ventricular beats (47 males, 49.83 ± 13.63 years) and 98 participants (55 males, 50.84 ± 9.41 years) whose age and gender were matched with the patient with PVCs. The baseline information and routine echocardiography detection were recorded on admission. PVCs were diagnosed by 24 h Holter monitoring, and cardiorespiratory capacity was assessed using peak oxygen uptake (V'Opeak), anaerobic threshold (AT), and other CPET parameters with an individualized bicycle ramp protocol according to the predicted workload and exercise situation of each participant. There were no statistically significant differences in most baseline characteristics between the two groups. Indicators that reflect cardiopulmonary capacity, such as V'Opeak, AT, and ΔO2 pulse/Δwork rate(ΔV'O/ΔWR), were all significantly lower in the PVC group ( = 0.031, 0.021, and 0.013, respectively) despite normal and nondiscriminatory left ventricular ejection fractions between the two groups. However, there was no statistically significant difference among subgroups based on the frequency of PVCs, which was <10,000 beats/24 h, 10,000-20,000 beats/24 h, and >20,000 beats/24 h. The cardiorespiratory capacity was lower in patients with frequent PVCs, indicating that CPET could detect early signs of impaired cardiac function induced by PVCs.

摘要

室性早搏(PVCs)诱发的心脏功能障碍在早期检测方面相对存在争议且具有挑战性。在这项观察性研究中,我们回顾性分析了94例频发室性早搏患者(47例男性,年龄49.83±13.63岁)以及98名年龄和性别与PVCs患者相匹配的参与者(55例男性,年龄50.84±9.41岁)的心肺运动试验(CPET)数据。入院时记录基线信息和常规超声心动图检测结果。通过24小时动态心电图监测诊断PVCs,并根据每位参与者的预测工作量和运动情况,采用个性化的自行车递增负荷方案,使用峰值摄氧量(V'Opeak)、无氧阈(AT)和其他CPET参数评估心肺功能。两组之间的大多数基线特征无统计学显著差异。尽管两组之间左心室射血分数正常且无差异,但反映心肺功能的指标,如V'Opeak、AT和ΔO2脉搏/Δ工作率(ΔV'O/ΔWR)在PVC组均显著降低(分别为 = 0.031、0.021和0.013)。然而,根据PVCs频率分组,即<10,000次/24小时、10,000 - 20,000次/24小时和>20,000次/24小时,各亚组之间无统计学显著差异。频发PVCs患者的心肺功能较低,表明CPET可以检测到PVCs诱发的心脏功能受损的早期迹象。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e17/10671195/ce50d18a14f9/healthcare-11-02940-g001.jpg

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