Pardaens K, Van Cleemput J, Vanhaecke J, Fagard R H
Department of Molecular and Cardiovascular Research, Faculty of Medicine, University of Leuven, Belgium.
Heart. 1997 Dec;78(6):564-8. doi: 10.1136/hrt.78.6.564.
To study the influence of atrial fibrillation on peak oxygen uptake (peak VO2) in chronic heart failure. An unfavourable effect of atrial fibrillation has been shown in several patient populations, but the results have not been consistent in chronic heart failure.
Data were analysed from male heart transplant candidates who were able to perform graded bicycle ergometry until exhaustion with respiratory gas analysis and measurement of heart rate. Patients in atrial fibrillation (n = 18) were compared with patients in sinus rhythm (n = 93).
Age, weight, height, and aetiology of chronic heart failure did not differ significantly between the two groups. Cardiac catheterisation at supine rest showed that heart rate was comparable, but that stroke volume and cardiac output were lower (p < 0.05) in atrial fibrillation. Systolic and diastolic left ventricular function, assessed by radionuclide angiography at rest, were not significantly different. Peak VO2 (mean (SD): 13.8 (3.6) v 17.1 (5.6) ml/kg/min; p < 0.01) and peak work load (78 (27) v 98 (36) W; p < 0.05) were lower in the patients with atrial fibrillation, though respiratory gas exchange ratio and Borg score were similar in the two groups. Patients with atrial fibrillation had a higher heart rate sitting at rest before exercise (93 (16) v 84 (16) beats/min) and at peak effort (156 (23) v 140 (25) beats/min) (p < 0.05).
Atrial fibrillation is associated with a 20% lower peak VO2 in patients with chronic heart failure, suggesting that preserved atrial contraction or a regular rhythm, or both, are critical to maintain cardiac output and exercise performance.
研究心房颤动对慢性心力衰竭患者峰值摄氧量（peak VO2）的影响。心房颤动在多个患者群体中已显示出不良影响，但在慢性心力衰竭患者中的结果并不一致。
对能够进行分级运动平板试验直至力竭并进行呼吸气体分析及心率测量的男性心脏移植候选者的数据进行分析。将心房颤动患者（n = 18）与窦性心律患者（n = 93）进行比较。
两组患者的年龄、体重、身高及慢性心力衰竭病因无显著差异。仰卧位静息时的心导管检查显示，心率相当，但心房颤动患者的每搏输出量和心输出量较低（p < 0.05）。静息时通过放射性核素血管造影评估的左心室收缩和舒张功能无显著差异。心房颤动患者的峰值VO2（均值（标准差）：13.8（3.6）对17.1（5.6）ml/kg/min；p < 0.01）和峰值工作量（78（27）对98（36）W；p < 0.05）较低，尽管两组的呼吸气体交换率和伯格评分相似。心房颤动患者运动前静息时（93（16）对84（16）次/分钟）及运动峰值时（156（23）对140（25）次/分钟）的心率较高（p < 0.05）。
心房颤动与慢性心力衰竭患者峰值VO2降低20%相关，提示保留心房收缩或规则心律，或两者兼具，对维持心输出量和运动能力至关重要。
