心力衰竭患者低强度运动期间的摄氧动力学：与神经激素、峰值耗氧量及临床 findings 的关系。 （注：这里“findings”直译为“发现”，结合语境可灵活处理，比如“表现”等，因未明确要求，暂保留英文）
Oxygen uptake kinetics during low level exercise in patients with heart failure: relation to neurohormones, peak oxygen consumption, and clinical findings.
作者信息
Brunner-La Rocca H P, Weilenmann D, Follath F, Schlumpf M, Rickli H, Schalcher C, Maly F E, Candinas R, Kiowski W
机构信息
Department of Internal Medicine, Division of Cardiology, University Hospital, Zurich, Switzerland.
出版信息
Heart. 1999 Feb;81(2):121-7. doi: 10.1136/hrt.81.2.121.
OBJECTIVE
To investigate whether oxygen uptake (VO2) kinetics during low intensity exercise are related to clinical signs, symptoms, and neurohumoral activation independently of peak oxygen consumption in chronic heart failure.
DESIGN
Comparison of VO2 kinetics with peak VO2, neurohormones, and clinical signs of chronic heart failure.
SETTING
Tertiary care centre.
PATIENTS
48 patients with mild to moderate chronic heart failure.
INTERVENTIONS
Treadmill exercise testing with "breath by breath" gas exchange monitoring. Measurement of atrial natriuretic factor (ANF), brain natriuretic peptide (BNP), and noradrenaline. Assessment of clinical findings by questionnaire.
MAIN OUTCOME MEASURES
O2 kinetics were defined as O2 deficit (time [rest to steady state] x DeltaVO2 -sigmaVO2 [rest to steady state]; normalised to body weight) and mean response time of oxygen consumption (MRT; O2 deficit/DeltaVO2).
RESULTS
VO2 kinetics were weakly to moderately correlated to the peak VO2 (O2 deficit, r = -0.37, p < 0.05; MRT, r = -0.49, p < 0.001). Natriuretic peptides were more closely correlated with MRT (ANF, r = 0.58; BNP, r = 0.53, p < 0.001) than with O2 deficit (ANF, r = 0.48, p = 0.001; BNP, r = 0.37, p < 0.01) or peak VO2 (ANF, r = -0.40; BNP, r = -0.31, p < 0.05). Noradrenaline was correlated with MRT (r = 0. 33, p < 0.05) and O2 deficit (r = 0.39, p < 0.01) but not with peak VO2 (r = -0.20, NS). Symptoms of chronic heart failure were correlated with all indices of oxygen consumption (MRT, r = 0.47, p < 0.01; O2 deficit, r = 0.39, p < 0.01; peak VO2, r = -0.48, p < 0. 01). Multivariate analysis showed that the correlation of VO2 kinetics with neurohormones and symptoms of chronic heart failure was independent of peak VO2 and other variables.
CONCLUSIONS
Oxygen kinetics during low intensity exercise may provide additional information over peak VO2 in patients with chronic heart failure, given the better correlation with neurohormones which represent an index of homeostasis of the cardiovascular system.
目的
研究慢性心力衰竭患者在低强度运动期间摄氧量（VO₂）动力学是否独立于峰值耗氧量，与临床体征、症状及神经体液激活相关。
设计
VO₂动力学与慢性心力衰竭患者的峰值VO₂、神经激素及临床体征的比较。
地点
三级医疗中心。
患者
48例轻至中度慢性心力衰竭患者。
干预措施
进行带“逐次呼吸”气体交换监测的跑步机运动试验。测量心钠素（ANF）、脑钠肽（BNP）及去甲肾上腺素。通过问卷调查评估临床发现。
主要观察指标
O₂动力学定义为O₂亏空（时间[静息至稳态]×ΔVO₂ - σVO₂[静息至稳态]；按体重标准化）及耗氧量的平均反应时间（MRT；O₂亏空/ΔVO₂）。
结果
VO₂动力学与峰值VO₂呈弱至中度相关（O₂亏空，r = -0.37，p < 0.05；MRT，r = -0.49，p < 0.001）。利钠肽与MRT的相关性（ANF，r = 0.58；BNP，r = 0.53，p < 0.001）比与O₂亏空（ANF，r = 0.48，p = 0.001；BNP，r = 0.37，p < 0.01）或峰值VO₂（ANF，r = -0.40；BNP，r = -0.31，p < 0.05）更密切。去甲肾上腺素与MRT（r = 0.33，p < 0.05）及O₂亏空（r = 0.39，p < 0.01）相关，但与峰值VO₂无关（r = -0.20，无显著性差异）。慢性心力衰竭症状与所有耗氧量指标相关（MRT，r = 0.47，p < 0.01；O₂亏空，r = 0.39，p < 0.01；峰值VO₂，r = -0.48，p < 0.01）。多变量分析显示，VO₂动力学与神经激素及慢性心力衰竭症状的相关性独立于峰值VO₂及其他变量。
结论
对于慢性心力衰竭患者，低强度运动期间的氧动力学可能比峰值VO₂提供更多信息，因为其与代表心血管系统内稳态指标的神经激素具有更好的相关性。
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