慢性心力衰竭患者运动峰值氧脉搏与峰值摄氧量的长期预后价值比较。
Comparison of the long-term prognostic value of peak exercise oxygen pulse and peak oxygen uptake in patients with chronic heart failure.
作者信息
Cohen-Solal A, Barnier P, Pessione F, Seknadji P, Logeart D, Laperche T, Gourgon R
机构信息
Service de Cardiologie, Hôpital Beaujon, Clichy, France.
出版信息
Heart. 1997 Dec;78(6):572-6. doi: 10.1136/hrt.78.6.572.
OBJECTIVE
To evaluate the ratio of peak oxygen consumption to peak heart rate (peak oxygen pulse) as a predictor of long term prognosis in chronic heart failure.
PATIENTS AND SETTING
178 consecutive heart failure patients recruited to the cardiology department of a tertiary referral centre between 1986 and 1993.
DESIGN
Bicycle ergometry with measurement of respiratory exchange. Mean (SD) follow up was 32 (25) months.
RESULTS
Patients who died had a lower peak oxygen consumption (16.0 (5.5) v 18.0 (5.5) ml/min/kg, p = 0.05), lower indexed peak oxygen consumption (52 (14) v 60 (16)%, p = 0.006) but similar peak oxygen pulse (8.4 (2.6) v 8.4 (3.0) ml/beat, NS). The following variables were associated with a good long term prognosis: New York Heart Association class II, non-ischaemic heart failure, peak oxygen consumption > or = 17 ml/min/kg, indexed peak oxygen consumption > 63%. Peak oxygen pulse did not have predictive value. Only indexed peak oxygen consumption remained an independent predictor of survival in multivariate analysis.
CONCLUSIONS
Peak oxygen pulse has lower prognostic value than peak oxygen consumption, especially when the latter is indexed to predicted values.
目的
评估峰值摄氧量与峰值心率之比（峰值氧脉搏）作为慢性心力衰竭长期预后的预测指标。
患者与研究背景
1986年至1993年间，一家三级转诊中心心内科连续招募的178例心力衰竭患者。
研究设计
采用自行车测力计进行运动试验并测量呼吸气体交换。平均（标准差）随访时间为32（25）个月。
结果
死亡患者的峰值摄氧量较低（16.0（5.5）对18.0（5.5）ml/分钟/千克，p = 0.05），校正后的峰值摄氧量较低（52（14）对60（16）%，p = 0.006），但峰值氧脉搏相似（8.4（2.6）对8.4（3.0）ml/次心跳，无显著性差异）。以下变量与良好的长期预后相关：纽约心脏协会II级、非缺血性心力衰竭、峰值摄氧量≥17 ml/分钟/千克、校正后的峰值摄氧量>63%。峰值氧脉搏无预测价值。在多变量分析中，只有校正后的峰值摄氧量仍然是生存的独立预测指标。
结论
峰值氧脉搏的预后价值低于峰值摄氧量，尤其是当后者校正为预测值时。
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