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成人先天性心脏病中的运动不耐受:比较严重程度,相关性和预后影响
Gerhard-Paul Diller1, Konstantinos Dimopoulos, Darlington Okonko
1Adult Congenital Heart Program, Department of Cardiology, Royal Brompton Hospital, London, UK.
Circulation
|August 3, 2005
概括
成年先天性心脏病 (ACHD) 患者的运动能力显著降低,即使在没有症状的患者中也是如此. 这种运动能力的降低,以峰值氧气消耗 (峰值VO2) 来衡量,是ACHD患者住院或死亡风险的关键指标.
科学领域:
- 心脏病学 心脏病学
- 运动生理学 运动生理学
- 成人的先天性心脏病 (ACHD)
背景情况:
- 成年先天性心脏病 (ACHD) 患者可能会经历运动限制.
- 假设:抑郁的运动能力在ACHD中很常见,可以预测风险.
研究的目的:
- 为了评估ACHD患者的运动能力.
- 为了确定是否行使能力预测在ACHD中不利的结果.
主要方法:
- 在335名ACHD患者,40名心力衰竭患者和23名健康对照中进行心肺运动测试 (CPET).
- 分析峰值氧气消耗 (峰值VO2) 和相关的数据.
- 多变量考克斯分析用于评估住院或死亡的预测.
主要成果:
- 与健康对照组相比,ACHD患者的VO2峰值显著降低.
- ACHD患者的VO2峰值与心力衰竭患者的峰值相当.
- 降低VO2峰值与心率峰值,肺高血压和肺功能受损相关.
- 峰值VO2预测住院或死亡 (HR 0.937,P = 0.01).
结论:
- 在ACHD患者中,运动能力受到抑制,类似于慢性心力衰竭.
- 诸如心率反应,肺高血压和肺功能等因素会影响运动能力.
- 较差的运动能力确定了ACHD患者的不良事件风险较高.
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