摘要
目的 探讨原发于左心的心力衰竭患者心肺运动试验（CEPT）二氧化碳排出通气有效性指标二氧化碳斜率（VE/VCO2slope）与超声心动图估测肺动脉收缩压（sPAP）之间的关系.方法 本研究为回顾性分析.入选病例为2012年12月至2014年7月间于阜外心血管病医院就诊并完成症状限制性最大极限CEPT的心力衰竭患者86例.根据CPET峰值摄氧量（peakVO2）,将患者分为心力衰竭轻度（peakVO2＞ 14 ml·kg-1·min-1）、中度（10 ml·kg-1·min-1＜peakVO2≤14 ml·kg-1·min-1）和重度（peakVO2≤10ml·kg-1 ·min-1）组,分别有23例、39例和24例.收集入选患者基本临床数据,采用Pearson法对VE/VCO2 slope与sPAP进行相关性分析,同时分析VE/VCO2slope估测sPAP的特异度和敏感度.结果 对于总体患者,VE/VCO2slope与sPAP显著相关（r=0.260,P=0.016）,VE/VCO2slope＞ 34.2估测sPAP ＞50 mmHg（1 mmHg =0.133 kPa）的敏感度为70.0％,特异度为64.3％.而心力衰竭轻度组患者VE/VCO2slope与sPAP相关性更为显著（r=0.686,P＜0.001）,VE/VCO2slope＞ 34.2估测sPAP＞ 50 mmHg的敏感度为71.4％,特异度为93.8％.结论 原发于左心的心力衰竭患者,VE/VCO2slope与超声心动图估测的sPAP显著相关,VE/VCO2slope＞ 34.2提示患者sPAP＞ 50 mmHg的可能性大.
Objective To explore the relationship between ventilator efficiency of cardiopulmonary exercising test （the slope of the relation between ventilation and carbon dioxide production,VE/VCO2 slope） and systolic pulmonary artery pressure （sPAP） measured by echocardiography in patients with chronic heart failure （HF）.Methods Data from 86 HF patients who were treated in Fuwai Hospital between December 2012 and July 2014 and performed the symptom limited maximal cardiopulmonary exercise test （CPET） and echocardiography were retrospectively analyzed.HF patients were divided into 3 groups （mild,moderate and severe） according to the maximum oxygenconsumption （peakVO2）.Results There is a significant linear correlation between VE/VCO2slope and sPAP （r =0.260,P =0.016）.Using VE/VCO2slope 〉 34.2 as a cutoff value to predict patients with sPAP 〉 50 mmHg （1 mmHg =0.133 kPa） yielded a sensitivity of 70.0% and a specificity of 64.3%.The degree of the linear correlation between VE/VCO2slope and sPAP is stronger in mild HF patients （peakVO2 〉 14 ml · kg 1 · min-1,r =0.686,P 〈 0.001）.Using VE/VCO2 slope 〉 34.2 as a cutoff value to predict sPAP 〉 50 mmHg in mild HF patients,the sensitivity is 71.4% and the specificity is 93.8%.Conclusion There is a significant linear correlation between VE/VCO2slope and sPAP in HF patients.VE/VCO2slope 〉 34.2 is linked with a high possibility of sPAP 〉 50 mmHg in HF patients,especially for patients with mild HF.Invasive hemodynamic examination and impact of special therapy are warranted in future studies to veryfy present results.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2015年第12期1028-1033,共6页
Chinese Journal of Cardiology
基金
国家高技术研究发展计划（863计划）（2012AA021009）
国家自然科学基金（81470204）
中国医学科学院国家心血管病中心科研开发启动基金（2012-YJR02）
关键词
心力衰竭
充血性
运动试验
Heart failure,congestive
Exercise test
