Xu Wenqing, Xiang Yin, Liu Bo, Yan Jianhua, Zhang Tingting, Yu Wanqi, Han Jia, Meng Shu
Department of Cardiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Department of Rehabilitation Medicine, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Front Cardiovasc Med. 2025 Apr 29;12:1459411. doi: 10.3389/fcvm.2025.1459411. eCollection 2025.
The clinical indicators of patients with coronary artery disease (CAD) often affect their prognosis. Cardiopulmonary Exercise Testing (CPET) can effectively evaluate the cardiopulmonary ability of CAD patients. The objective of this research was to explore the correlation between some clinical indicators and peak metabolic equivalents (peak METs) and peak oxygen pulse (OP) in patients with CAD. Regression equations were further constructed for indicators with significant correlations to predict peak METs and OP.
152 CAD patients were recruited (M: F = 109:43, age = 64.47 ± 7.80 years, including 32 patients with chronic myocardial infarction, 46 with frailty, 93 with hypertension, and 48 with diabetes). All participants had blood biochemistry analysis, cardiac ultrasound, CPET and five time sit-to-stand (FTSTS) test. CPET was tested according to an incremental loading scheme of 10-15 w/min and peak METs, OP were recorded. Stepwise multifactorial linear regression was used to determine which clinical variables should be adjusted to improve peak METs and OP.
Results of multifactorial linear regression showed 2 equations: peak METs = 6.768-0.116BMI + 0.018Hgb-0.026age-0.005Gensini score (Adjusted R = 0.301, F = 17.239, < 0.001); OP = -1.066 + 0.264BMI + 0.049Hgb-0.035*age (Adjusted R = 0.382, F = 32.106, < 0.001).
BMI, Hgb, age and Gensini score can be used to predict peak METs and BMI, Hgb and age can be used to predict OP in patients with CAD clinically. Thus, tailored exercise program should be prescribed for individual CAD patient undergoing cardiac rehabilitation and modifying clinical factors such as BMI, Hgb and Gensini score will help to improve their cardiorespiratory fitness and quality of life.
冠心病(CAD)患者的临床指标常影响其预后。心肺运动试验(CPET)能有效评估CAD患者的心肺功能。本研究目的是探讨CAD患者某些临床指标与峰值代谢当量(peak METs)及峰值氧脉搏(OP)之间的相关性。对具有显著相关性的指标进一步构建回归方程以预测peak METs和OP。
招募152例CAD患者(男∶女 = 109∶43,年龄 = 64.47±7.80岁,包括32例慢性心肌梗死患者、46例虚弱患者、93例高血压患者和48例糖尿病患者)。所有参与者均进行血液生化分析、心脏超声检查、CPET及五次坐立试验(FTSTS)。CPET按照10 - 15瓦/分钟的递增负荷方案进行测试,并记录peak METs和OP。采用逐步多因素线性回归确定应调整哪些临床变量以改善peak METs和OP。
多因素线性回归结果显示2个方程:peak METs = 6.768 - 0.116×BMI + 0.018×Hgb - 0.026×年龄 - 0.005×Gensini评分(调整后R = 0.301,F = 17.239,P < 0.001);OP = -1.066 + 0.264×BMI + 0.049×Hgb - 0.035×年龄(调整后R = 0.382,F = 32.106,P < 0.001)。
BMI、Hgb、年龄和Gensini评分可用于临床预测CAD患者的peak METs,BMI、Hgb和年龄可用于预测CAD患者的OP。因此,应为接受心脏康复的个体CAD患者制定个性化运动方案,调整BMI、Hgb和Gensini评分等临床因素将有助于改善其心肺适能和生活质量。