Jung Mi-Hyang, Lee So-Young, Chung Woo-Baek, Youn Jong-Chan, Jung Hae Ok
Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
Diagnostics (Basel). 2025 May 23;15(11):1307. doi: 10.3390/diagnostics15111307.
: Understanding normal exercise hemodynamics is essential for assessing individuals with exertional dyspnea. This study utilized exercise echocardiography to gain insights into exercise hemodynamics in asymptomatic middle-aged to older adults without overt cardiovascular disease. : We prospectively enrolled 30 individuals aged 45-75 years without dyspnea, excluding those with left ventricular ejection fraction (LVEF) < 50% or significant heart/lung diseases. All participants underwent symptom-limited bicycle exercise echocardiography. : Two individuals exhibited early-stage dyspnea, leading to the inclusion of 28 individuals (mean age 61 ± 8 years, 50% female) in the final analysis. Throughout the exercise, the average E/e' ratio increased from 8.3 ± 1.6 at rest to 9.7 ± 1.8 at 75 W ( = 0.001), while systolic pulmonary artery pressure (SPAP) rose from 23.0 ± 3.9 mmHg at rest to 41.2 ± 9.3 mmHg at 75 W ( < 0.001). Sex-specific analysis revealed a more pronounced elevation in SPAP during exercise among females (SPAP at 75 W, 45.5 ± 8.3 in females; 36.8 ± 8.3 mmHg in males, = 0.011; < 0.001 for interaction between sexes). : In asymptomatic middle-aged to older adults, while there was a slight increase in left ventricular filling pressure and SPAP during exercise, the mean average E/e' and SPAP at peak exercise were below 10 and 50 mmHg, respectively. Our findings also demonstrate sex-specific differences, with females exhibiting a more pronounced elevation in SPAP during exercise.
了解正常运动血流动力学对于评估劳力性呼吸困难患者至关重要。本研究利用运动超声心动图来深入了解无症状的中年至老年且无明显心血管疾病的成年人的运动血流动力学。我们前瞻性纳入了30名年龄在45 - 75岁之间且无呼吸困难的个体，排除左心室射血分数（LVEF）< 50%或患有严重心肺疾病的个体。所有参与者均接受症状限制的踏车运动超声心动图检查。两名个体出现早期呼吸困难，最终分析纳入了28名个体（平均年龄61 ± 8岁，50%为女性）。在整个运动过程中，平均E/e'比值从静息时的8.3 ± 1.6增加到75 W时的9.7 ± 1.8（P = 0.001），而收缩期肺动脉压（SPAP）从静息时的23.0 ± 3.9 mmHg上升到75 W时的41.2 ± 9.3 mmHg（P < 0.001）。性别特异性分析显示，女性在运动期间SPAP升高更为明显（75 W时女性的SPAP为45.5 ± 8.3；男性为36.8 ± 8.3 mmHg，P = 0.011；性别间交互作用P < 0.001）。在无症状的中年至老年成年人中，虽然运动期间左心室充盈压和SPAP略有增加，但运动峰值时的平均E/e'和SPAP分别低于10和50 mmHg。我们的研究结果还表明存在性别特异性差异，女性在运动期间SPAP升高更为明显。
