在心力衰竭患者中使用心电图实时估计运动期间的无氧值
Toshinobu Ryuzaki1,2, Yasuyuki Shiraishi1,2, Kotaro Miura1,2
1Department of Cardiology, Keio University School of Medicine, Tokyo 160-8582, Japan.
Journal of clinical medicine
|August 26, 2023
概括
心力衰竭患者可以使用心率变化 (HRV) 分析从心电图 (ECG) 来估计他们的无氧值 (AT). 当心肺运动测试 (CPX) 无法使用时,这种方法提供了一个潜在的替代方案.
科学领域:
- 心脏病学 心脏病学
- 运动生理学 运动生理学
- 生物医学工程 生物医学工程
背景情况:
- 有氧运动治疗改善了心力衰竭患者的结果.
- 心肺运动测试 (CPX) 对于确定无氧值 (ATs) 是必不可少的,但缺乏广泛的可用性.
- 对于心力衰竭的管理,需要一种非CPX方法来估计AT.
研究的目的:
- 验证一种用于估计心力衰竭患者无氧值 (AT) 的新方法.
- 评估从心电图 (ECG) 数据中得出的心率变化 (HRV) 值 (HRVT) 的实用性.
- 通过CPX将HRVT估计与传统的AT确定进行比较.
主要方法:
- 67名有症状的心力衰竭的患者接受了CPX,并进行了连续RR间隔测量.
- 用高频组件 (HFC) 的功率谱分析计算心率变化值 (HRVT).
- 根据休息时的HFC,患者被分为高HFC和低HFC组.
主要成果:
- 高HFC组在AT和HRVT的VO2之间显示出显著的相关性 (r=0.63,p<0.001) 和强烈的一致性 (平均差异-0.38毫升/千克,p=0.571).
- 低碳化合物组在AT和HRVT的VO2之间显示了适度的相关性 (r=0.41,p=0.017),但缺乏一致性 (平均差异3.75毫升/千克,p<0.001).
- HRVT估计在患有更高休息高频率心率波动的患者中显示出更好的准确性.
结论:
- 从心电图得出的心率变化值 (HRVT) 显示出对估计心力衰竭患者无氧值 (AT) 的前景.
- 这种非侵入性方法可以作为CPX的实际替代方案,特别是在资源有限的临床环境中.
- 需要进一步验证,特别是考虑到患者群体之间的精度差异.
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