中国全科医学2016，Vol.19Issue(35)：4310-4315,6.DOI:10.3969/j.issn.1007-9572.2016.35.005
重度心力衰竭患者心肺运动试验安全性和可行性分析
Safety and Feasibility of Cardiopulmonary Exercise Testing in Patients with Severe Heart Failure
摘要
Abstract
Background Cardiopulmonary exercise testing(CPET)is the unique method and clinical technology for estimating integrative functional status objectively and quantitatively,which is widely used in management for heart and lung transplantation. With worries over insurance,many domestic specialists abandon evaluating the patients with severe heart failure objectively and quantitatively by using CPET. Objective To retrospectively evaluate the safety and feasibility of CPET in patients with severe heart failure. Methods In cardiopulmonary exercise test room of Fuwai Hospital,Chinese Academy of Medical Sciences,77 patients with severe heart failure who were waiting for heart transplantation,underwent CPET during December 2013 to November 2015,they were selected as study subjects,among whom 32 cases were rated as grade Ⅲ,45 cases were rated as grade Ⅳ according to New York Heart Association( NYHA)functional classification,all cases completed symptom - limited extreme exercise according to standard continuous incremental power scheme of Harbor - UCLA Medical Center. Pulmonary function indexes,common indexes,and CPET parameters were detected,the primary reasons for stopping CPET were recorded. Results There were no significant differences in peak anaerobic threshold( ml/ min,ml · min - 1 · kg - 1 ,% pred),peak oxygen uptake(ml/ min,ml·min - 1 ·kg - 1 ,% pred),oxygen pulse(ml/ time,% pred),oxygen uptake efficiency platform(OUEP)(ratio,% pred),equivalent minimum value of carbon dioxide ventilation(ratio,% pred),carbon dioxide ventilation slope(slope,% pred)between NYHA functional classification grade Ⅲ patients and grade Ⅳ patients(P >0. 05). The most common reason for stopping exercise was fatigue(n = 38,49. 3% ),and other reasons including dyspnea(n= 20,26. 0% ),chest distress(n = 7,9. 1% ),dizziness(n = 5,6. 5% ),dry mouth(n = 4,5. 2% ),palpitation( n= 2,2. 6% ),and nausea( n = 1,1. 3% ). There was no significant difference between patients with NYHA functional classification grade Ⅲ and Ⅳ in the reasons of stopping exercise( P = 0. 442). Conclusion Because there is no significant abnormality in pulmonary function indexes,common indexes,and CPET parameters,it is safe and feasible to perform CPET in patients with severe heart failure. There are no statistical difference in the CPET parameters and reasons of stopping exercise between patients with NYHA functional classification grade Ⅲ and gradeⅣ.关键词
心力衰竭/心肺运动试验/治疗结果/安全Key words
Heart failure/Cardiopulmonary exercise testing/Treatment outcome/Safety分类
医药卫生引用本文复制引用
尚广配,孙兴国,谭晓越,葛万刚,刘方..重度心力衰竭患者心肺运动试验安全性和可行性分析[J].中国全科医学,2016,19(35):4310-4315,6.基金项目
国家高技术研究发展计划（863计划）课题（2012AA021009）；国家自然科学基金医学科学部面上项目（81470204）；中国医学科学院国家心血管病中心阜外医院科研开发启动基金（2012- YJR02）；首都临床特色应用研究 （）
