广西医学2023，Vol.45Issue(19)：2335-2342,8.DOI:10.11675/j.issn.0253-4304.2023.19.08
急性心肌梗死后心力衰竭患者运动能力的影响因素及列线图预测模型的构建
Influencing factors for exercise ability in patients with heart failure after acute myocardial infarction and the establishment of nomogram prediction model
摘要
Abstract
Objective To explore the exercise ability and its influencing factors in patients with heart failure after acute myocardial infarction,and to establish a nomogram prediction model.Methods A total of 315 patients with heart failure after acute myocardial infarction were selected as the research subjects,and they were assigned to modeling group(221 cases)or validation group(94 cases)according to sequence of investigation.All patients received cardiopulmonary exercise testing,according to the presence of oscillatory breathing(OB),patients in the modeling group were divided into OB positive group(n = 85)or OB negative group(n = 136).The influencing factors for exercise ability in patients with heart failure after acute myocardial infarction were analyzed by using the Logistic regression model,and based on these influencing factors,the nomogram prediction model was established and validated.Results The positive rate of OB was 39.37%among 315 patients with heart failure after acute myocardial infarction.The results of multivariate Logistic regression analysis revealed that categories of concomitant chronic diseases,body mass index,New York Heart Association(NYHA)cardiac function classification,the Chinese version of Tampa Scale for Kinesiophobia Heart(TSK-Heart-C)score,score of knowledge-belief-practice questionnaire of rehabilitation exercise in patients with coronary heart disease,and Chinese version Brief Illness Perception Questionnaire(B-IPQ)score were the independent influencing factors for exercise ability in patients with heart failure after acute myocardial infarction(P<0.05).The nomogram prediction model established based on the aforementioned influencing factors exerted favorable discrimination and calibration.The results of decision curve analysis indicated that when the threshold probabilities were 2%-88%and 1%-95%,respectively,the net benefit value of the model in predicting exercise ability in patients with heart failure after acute myocardial infarction was relatively high.Conclusion The exercise ability of patients with heart failure after acute myocardial infarction is weak.Categories of concomitant chronic diseases,body mass index,NYHA cardiac function classification,TSK-Heart-C score,score of knowledge-belief-practice questionnaire of rehabilitation exercise in patients with coronary heart disease,and Chinese version B-IPQ score are the independent influencing factors for exercise ability in patients with heart failure after acute myocardial infarction.The nomogram prediction model established based on the influencing factors as above is helpful for clinicians to evaluate the exercise ability of this population.关键词
急性心肌梗死/心力衰竭/运动能力/影响因素/预测模型Key words
Acute myocardial infarction/Heart failure/Exercise ability/Influencing factors/Prediction model分类
医药卫生引用本文复制引用
韦静,林桦,李春燕,蒙玉民,黄小晶,罗雪,余湘宁,宋静雯..急性心肌梗死后心力衰竭患者运动能力的影响因素及列线图预测模型的构建[J].广西医学,2023,45(19):2335-2342,8.基金项目
广西科技计划项目(桂科AB22080079) （桂科AB22080079）
广西壮族自治区卫生健康委员会自筹经费科研课题(Z20210787) （Z20210787）
