运动测试预测了初级预防人口中的非心血管和心血管死亡
Nóra Sydó1, Umair Iftikhar2, Emese Csulak3
1Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA; Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
Mayo Clinic proceedings
|September 3, 2023
概括
运动测试异常预测心血管和非心血管死亡. 低有氧容量,心率恢复不良和低慢性指数是非心血管死亡率的重要预测因素.
科学领域:
- 心脏病学 心脏病学
- 预防医学 预防医学
- 运动生理学 运动生理学
背景情况:
- 非心血管 (非CV) 死亡在被转诊进行运动测试的个体中很普遍.
- 了解非CV死亡率的预测因素对于全面的风险评估至关重要.
研究的目的:
- 为了确定在运动测试参考人群中非CV死亡的患病率.
- 为了确定非CV死亡率的特定原因.
- 评估运动测试参数是否预测非CV死亡,类似于心血管 (CV) 死亡.
主要方法:
- 对13,382名患者 (年龄在30-79岁之间) 的非成像性运动测试进行了回顾性审查.
- 排除具有基线心血管疾病的患者;从医疗记录和死亡指数中获得的死亡数据.
- 运动测试异常的分析,包括功能性有氧能力,心率恢复,慢热指数和运动心电图 (ECG) 以及复合得分 (EX_SCORE).
- 对多种风险因素进行调整的考克斯回归分析.
主要成果:
- 在随访期间 (12.7±5.0年),发生了849例死亡 (6.3%),其中80.9%为非CV.
- 低功能性有氧容量 (HR 1.42),异常心率恢复 (HR 1.36) 和低慢性热量指数 (HR 1.49) 显著预测了非心血管疾病死亡.
- 异常的运动心电图没有预测非心血管死亡.
- 大多数运动测试异常与心血管死亡的相关性比非心血管死亡更强.
结论:
- 在这个初级预防队列中,非CV死亡占主导地位.
- 运动测试参数除了预测心血管疾病事件之外,还可以作为非心血管疾病死亡率的重要预测指标.
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