El Shaer Ahmed, Garcia-Arango Mariana, Abed Anas, Heffernan Shannon, Wang Yuning, Javed Tashfeen, Esmaeeli Amirhossein, Arif Abdul Wahab, Tao Ran, Dharmavaram Naga, Runo James, Barnes Jill N, Raza Farhan
Department of Internal Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Division of Cardiovascular Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Physiol Rep. 2025 Apr;13(7):e70337. doi: 10.14814/phy2.70337.
Poor recovery pattern of oxygen consumption (V̇O) post-exercise is associated with adverse clinical outcomes. However, it remains unknown which component of the O pathway (Fick principle) defines this prognostic risk, for example, peripheral extraction, stroke volume, heart rate. Retrospective cohort study included 120 participants (heart failure with preserved ejection fraction: HFpEF = 68, pre-capillary pulmonary hypertensio n = 31, non-cardiac dyspnea = 21). Percent recovery metrics were calculated as the percent reduction of each hemodynamic variable from peak exercise to recovery, for example, (exercise-recovery)/exercise ×100%. Overall, the mean age (standard deviation) was 62.6 (14.4) years and 54% were females. Among the three groups (HFpEF, pre-capillary pulmonary hypertension, non-cardiac dyspnea), recovery patterns of O pathway components were statistically non-significant. Peripheral extraction recovery (r = 0.43, p < 0.001) and heart rate recovery (r = 0.25, p < 0.001) correlated with peak V̇O, but only peripheral extraction recovery remained significant in multivariate analysis (p = 0.01). Peripheral extraction recovery (<41%; median) demonstrated poor one-year survival from mortality and heart failure hospitalizations (HR 2.82; CI 95% 1.38-5.74, p = 0.003). Peripheral extraction recovery pattern is the most significant component of the O pathway and defines adverse outcomes. Physiologically, it elucidates the importance of skeletal muscle and peripheral vascular function.
运动后氧耗（V̇O）恢复模式不佳与不良临床结局相关。然而，尚不清楚氧代谢途径（菲克原理）的哪个组成部分决定了这种预后风险，例如，外周摄取、每搏输出量、心率。回顾性队列研究纳入了120名参与者（射血分数保留的心力衰竭：HFpEF = 68例，毛细血管前肺动脉高压 = 31例，非心源性呼吸困难 = 21例）。恢复百分比指标计算为每个血流动力学变量从运动峰值到恢复的减少百分比，例如，（运动值 - 恢复值）/运动值×100%。总体而言，平均年龄（标准差）为62.6（14.4）岁，54%为女性。在三组（HFpEF、毛细血管前肺动脉高压、非心源性呼吸困难）中，氧代谢途径各组成部分的恢复模式在统计学上无显著差异。外周摄取恢复（r = 0.43，p < 0.001）和心率恢复（r = 0.25，p < 0.001）与峰值V̇O相关，但在多变量分析中只有外周摄取恢复仍具有显著性（p = 0.01）。外周摄取恢复（<41%；中位数）显示因死亡和心力衰竭住院导致的一年生存率较差（HR 2.82；95% CI 1.38 - 5.74，p = 0.003）。外周摄取恢复模式是氧代谢途径中最显著的组成部分，并决定了不良结局。从生理角度来看，它阐明了骨骼肌和外周血管功能的重要性。
