心肺运动测试参数的预测值在接受皮肤冠状动脉干预的高脉压患者中
Qiang Ren1,2, Xingbo Mu1,2, Yushan Li1
1State Key Laboratory of Frigid Zone Cardiovascular Diseases, Department of Cardiology, General Hospital of Northern Theater Command, 110016 Shenyang, Liaoning, China.
Reviews in cardiovascular medicine
|March 3, 2025
概括
心肺运动测试 (CPET) 参数,如氧气吸收峰值和二氧化碳的呼吸器等效预测冠状动脉疾病 (CAD) 患者进行皮肤冠状动脉干预 (PCI) 和高脉压 (PP) 的结果. 这些CPET指标为高风险的CAD患者提供了有价值的预后见解.
科学领域:
- 心脏病学 心脏病学
- 运动生理学 运动生理学
- 医学预测 医学预测
背景情况:
- 在接受皮肤冠状动脉干预 (PCI) 的患者中,高脉压 (PP) 具有不清楚的预后影响.
- 冠状动脉疾病 (CAD) 管理需要更好地了解特定患者亚组的风险分层.
研究的目的:
- 调查心肺运动测试 (CPET) 参数与接受PCI和高PP的CAD患者的预后之间的相关性.
- 评估CPET参数对该人群中主要心血管不良事件 (MACE) 的预测值.
主要方法:
- 在2015年11月至2021年9月期间接受PCI和CPET的2785名患者 (年龄≥18) 的回顾性分析.
- 患者被分为高PP (男性≥50 mmHg,女性≥60 mmHg) 和正常PP组.
- 考克斯回归和时间依赖的ROC曲线分析确定了MACE的预测因素.
主要成果:
- 氧气吸收峰值 (VO2峰值) 和呼吸系统对二氧化碳 (VE/VCO2) 的同等值被确定为MACE的显著预测因素.
- 多因素分析显示,高峰VO2 (HR:0.94) 和 VE/VCO2 (HR:1.08) 是CPET的主要预后因素.
- 一个包含DM,吸烟,峰值VO2和VE/VCO2的ROC模型显示出对1,3年和5年的预后有很好的区分能力.
结论:
- 经过PCI和高PP的CAD患者与正常PP患者相比,预后更差.
- 峰值VO2和VE/VCO2是高PP的CAD患者中MACE的关键预测因素.
- CPET参数为接受PCI的高PP风险分层患者提供了有价值的预后信息.
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