Chaliki Kalyan, Sharma Arundhati, Sharma Anubhuti, Yee Claire, Chaliki Hari, Reddy Satyajit
Division of Cardiology, The University of Arizona College of Medicine-Phoenix, Phoenix, AZ 85004, USA.
Department of Cardiovascular Diseases, Mayo Clinic, Scottsdale, AZ 85054, USA.
J Clin Med. 2025 Apr 27;14(9):3013. doi: 10.3390/jcm14093013.
: The peak oxygen consumption (VO2) during cardiopulmonary exercise testing (CPET) is a strong predictor of all-cause mortality. The cardiac output, a key determinant of VO2, can be assessed using resting echocardiographic parameters. The heart rate recovery and ventilatory efficiency (VE/VCO2 slope) from CPET offer additional insights into cardiovascular fitness. : This study aimed to identify resting echocardiographic parameters that predict the percentage of predicted peak VO2, heart rate recovery, and VE/VCO2 slope in a general cardiology population. This retrospective analysis included 1909 patients who underwent echocardiography within 3 months of CPET from 2017 to 2022. Patients with potentially confounding co-morbid conditions were removed. Spearman correlations were used to compare 19 echocardiographic parameters to peak VO2, heart rate recovery, and the VE/VCO2 slope, followed by multiple linear regression of peak VO2. : Eleven echocardiographic parameters correlated with peak VO2, with the strongest correlations seen with the left ventricular stroke volume index (R = 0.284, < 0.001), mitral valve medial annular a' wave velocity (R = 0.142, < 0.0001), and mitral E-to-e' ratio (R = -0.117, < 0.0001). The left ventricular diastolic parameters and mitral E/A ratio correlated strongly with the heart rate recovery and VE/VCO2 slope. The multiple linear regression analysis identified the left ventricular mass index, stroke volume index, mitral valve E wave velocity, tricuspid valve regurgitation peak systolic velocity, tricuspid lateral annular systolic velocity S', and left atrial volume index as independent predictors of peak VO2 (R = 0.191). : The left ventricular stroke volume, diastolic function, and RV systolic function markers are significant predictors of cardiopulmonary fitness, aiding clinical decision-making in patients without CPET data.
心肺运动试验（CPET）期间的峰值耗氧量（VO₂）是全因死亡率的有力预测指标。心输出量是VO₂的关键决定因素，可使用静息超声心动图参数进行评估。CPET中的心率恢复和通气效率（VE/VCO₂斜率）为心血管健康状况提供了更多见解。
本研究旨在确定静息超声心动图参数，以预测普通心脏病患者中预测峰值VO₂的百分比、心率恢复情况和VE/VCO₂斜率。这项回顾性分析纳入了2017年至2022年在CPET后3个月内接受超声心动图检查的1909例患者。排除了存在潜在混淆性合并症的患者。使用Spearman相关性分析比较19项超声心动图参数与峰值VO₂、心率恢复情况和VE/VCO₂斜率，随后对峰值VO₂进行多元线性回归分析。
11项超声心动图参数与峰值VO₂相关，其中与左心室每搏输出量指数相关性最强（R = 0.284，P < 0.001）、二尖瓣内侧环a'波速度（R = 0.142，P < 0.0001）和二尖瓣E/e'比值（R = -0.117，P < 0.0001）。左心室舒张参数和二尖瓣E/A比值与心率恢复情况和VE/VCO₂斜率密切相关。多元线性回归分析确定左心室质量指数、每搏输出量指数、二尖瓣E波速度、三尖瓣反流峰值收缩期速度、三尖瓣外侧环收缩期速度S'和左心房容积指数为峰值VO₂的独立预测指标（R = 0.191）。
左心室每搏输出量、舒张功能和右心室收缩功能指标是心肺适能的重要预测指标，有助于在没有CPET数据的患者中进行临床决策。
