左心室功能的动态监测：充血性心力衰竭患者的步行和自行车运动

Ambulatory monitoring of left ventricular function: walk and bicycle exercise in congestive heart failure.

作者信息

Nappi A, Cuocolo A, Imbriaco M, Nicolai E, Varrone A, Morisco C, Romano M, Trimarco B, Salvatore M

机构信息

Nuclear Medicine Center of the National Council of Research (CNR) and Internal Medicine, University Federico II, Napoli, Italy.

出版信息

J Nucl Med. 1997 Jun;38(6):948-53.

PMID:9189148

Abstract

UNLABELLED

The aim of this study was to assess changes in left ventricular (LV) function during 6-min walk test and cardiopulmonary exercise by continuous radionuclide monitoring in patients with congestive heart failure (CHF).

METHODS

Seventeen patients with CHF and 10 normal subjects underwent monitoring of LV function (Vest) during 6-min walk test and during bicycle exercise with combined analysis of pulmonary gas exchange. During cardiopulmonary exercise, all parameters of LV function were measured at rest, at the anaerobic threshold (AT) and at peak oxygen uptake (peak VO2).

RESULTS

In the normal subjects, during the walk test, heart rate (HR), ejection fraction (EF), end-diastolic volume (EDV), cardiac output (CO) and stroke volume (SV) significantly increased from rest to peak (all p < 0.001), while end-systolic volume (ESV) significantly decreased from rest to peak (p < 0.001). In patients with CHF, during the walk test, HR, EDV, ESV and CO significantly increased from rest to peak (p < 0.001), EF significantly decreased from rest to peak (p < 0.001) and SV did not show significant change. During cardiopulmonary exercise, normal subjects showed a significant increase in HR and CO, from rest to AT and from AT to the peak VO2 (p < 0.001). EF, EDV and SV significantly increased from rest to AT (p < 0.001), with no significant change from AT to peak VO2. ESV decreased from rest to AT (p < 0.001), showing no significant change from AT to peak VO2. In patients with CHF, HR, CO, ESV and EDV increased significantly from rest to AT (p < 0.001) and from AT to peak VO2 (p < 0.001). EF and SV did not show significant changes from rest to AT, showing a significant decrease from AT to peak VO2 (p < 0.001).

CONCLUSION

Vest can be used to evaluate cardiac responses during 6-min walk test and cardiopulmonary exercise in patients with CHF. In such patients, significant impairment of LV function is already present during submaximal physical exercise becoming more evident during the anaerobic phases of bicycle exercise.

摘要

未标注

本研究的目的是通过连续放射性核素监测评估充血性心力衰竭（CHF）患者在6分钟步行试验和心肺运动期间左心室（LV）功能的变化。

方法

17例CHF患者和10名正常受试者在6分钟步行试验和自行车运动期间接受LV功能（背心式）监测，并结合分析肺气体交换情况。在心肺运动期间，在静息状态、无氧阈值（AT）和峰值摄氧量（峰值VO₂）时测量LV功能的所有参数。

结果

在正常受试者中，在步行试验期间，心率（HR）、射血分数（EF）、舒张末期容积（EDV）、心输出量（CO）和每搏输出量（SV）从静息到峰值均显著增加（均p<0.001），而收缩末期容积（ESV）从静息到峰值显著降低（p<0.001）。在CHF患者中，在步行试验期间，HR、EDV、ESV和CO从静息到峰值显著增加（p<0.001），EF从静息到峰值显著降低（p<0.001），SV未显示显著变化。在心肺运动期间，正常受试者的HR和CO从静息到AT以及从AT到峰值VO₂均显著增加（p<0.001）。EF、EDV和SV从静息到AT显著增加（p<0.001），从AT到峰值VO₂无显著变化。ESV从静息到AT降低（p<0.001），从AT到峰值VO₂无显著变化。在CHF患者中，HR、CO、ESV和EDV从静息到AT以及从AT到峰值VO₂均显著增加（p<0.001）。EF和SV从静息到AT未显示显著变化，从AT到峰值VO₂显著降低（p<0.001）。