循环运动测试中的心率反应和恢复:正常值和与死亡率的关联
Jordi Jou1, Xingwu Zhou1,2, Thomas Lindow3,4
1Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden.
European journal of preventive cardiology
|September 26, 2024
概括
减弱心率 (HR) 的恢复和反应与死亡风险有关. 功能障碍的HR恢复是所有死因的强有力的预测因素,即使在正常运动能力的个体中也是如此.
科学领域:
- 心脏病学 心脏病学
- 运动生理学 运动生理学
- 预防医学 预防医学
背景情况:
- 慢性无能和心率恢复受损与死亡率增加有关.
- 目前的临床指南缺乏心率恢复的具体参考值.
- 确定正常心率反应和恢复值对于风险分层至关重要.
研究的目的:
- 定义心率峰值,心率储备和心率恢复的正常参考值.
- 调查心率指数减弱与全因和心血管死亡率之间的关联.
- 为了评估结合形心率指数的预后价值.
主要方法:
- 分析了9917名受试者 (45%为女性,年龄在18-85岁之间) 的数据,这些受试者接受了循环运动测试.
- 基于2242个看似健康的个人的正常心率指数的定义.
- 考克斯回归和竞争性风险分析,以评估与心率指数 (<第5百分位数) 减弱相关的死亡风险,平均随访时间为8.6年.
主要成果:
- 所有心率指数 (高峰HR,HR储备,HRR1,HRR2) 都是所有原因和心血管死亡率的年龄依赖和独立预测指标.
- 减弱心率恢复变量 (HRR1和HRR2) 是所有原因死亡率的最强预测因素,无论是整体人口还是正常运动能力的受试者.
- 结合形心率指数似乎增加了全因和心血管死亡的风险,这表明增加了预后价值.
结论:
- 年龄相关的心率指数与全因和心血管死亡率有显著的关联.
- 心率恢复障碍是所有原因死亡率的强有力的预测因素,无论运动能力如何.
- 减弱心率指数的组合可以提高对死亡风险的预后评估.
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