de Vries R J, van Veldhuisen D J, Dunselman P H, van der Veer N, Crijns H J
Department of Cardiology, University Hospital Groningen, The Netherlands.
Eur Heart J. 1997 Dec;18(12):1921-30. doi: 10.1093/oxfordjournals.eurheartj.a015201.
To analyse the relationship between initial exercise parameters and peak oxygen consumption and prognosis in 96 patients with congestive heart failure.
Comparison of responses during the initial 6 min of cardiopulmonary exercise testing (Naughton modified protocol) in patients stratified to the Weber classification, and analysis of their predictive value with respect to peak oxygen uptake and prognosis. All patients had a left ventricular ejection fraction < 0.45 and a valid cardiopulmonary exercise test, during which they remained in sinus rhythm. Significant differences in several parameters were seen in the initial stages, including oxygen pulse (P < 0.04) and ventilation equivalent for oxygen (P < 0.004). These parameters remained as independent predictors of peak oxygen uptake in the algorithm derived from baseline and initial stage variables. In a multivariate Cox proportional hazards model, the predicted peak oxygen uptake (P < 0.003) was an independent predictor of mortality.
In patients with congestive heart failure, the initial 6 min parameters of a cardiopulmonary exercise test have additional value in the assessment of clinical severity and prognosis. This may be of clinical relevance since a limited incremental exercise protocol may be more objective than more traditional 6 min walking tests and less demanding.
分析96例充血性心力衰竭患者初始运动参数与峰值耗氧量及预后之间的关系。
对按韦伯分类分层的患者在心肺运动试验（诺顿改良方案）最初6分钟内的反应进行比较，并分析其对峰值摄氧量和预后的预测价值。所有患者左心室射血分数<0.45且心肺运动试验有效，试验期间保持窦性心律。在初始阶段观察到几个参数存在显著差异，包括氧脉搏（P<0.04）和氧通气当量（P<0.004）。在从基线和初始阶段变量得出的算法中，这些参数仍然是峰值摄氧量的独立预测因子。在多变量Cox比例风险模型中，预测的峰值摄氧量（P<0.003）是死亡率的独立预测因子。
在充血性心力衰竭患者中，心肺运动试验最初6分钟的参数在评估临床严重程度和预后方面具有额外价值。这可能具有临床相关性，因为有限的递增运动方案可能比更传统的6分钟步行试验更客观且要求更低。
