PURPOSE:In patients with systolic heart failure, the ability of cardiopulmonary exercise testing (CPX) variables to reflect pathophysiology is well established. The relationship between CPX and pathophysiology has, however, not been thoroughly investigated in patients with nonobstructive hypertrophic cardiomyopathy (NHCM). The objective of this study was to assess the ability of CPX variables to reflect resting hemodynamics in patients with nonobstructive hypertrophic cardiomyopathy NHCM. METHODS:We performed CPX and right heart catheterization on 83 subjects with NHCM (51 male/32 female, mean age = 38 +/- 10 yr, NYHA I-III mean = 1.7). Peak oxygen consumption ( O2) and minute ventilation/carbon dioxide ratio (V E/VCO2) at peak exercise were compared to resting hemodynamics including pulmonary artery systolic, diastolic and mean pressures (PASP, PADP and MPAP), and pulmonary capillary wedge pressure (PCWP). RESULTS:Elevations in PCWP (> or = 15 mm Hg), PASP (> or =30 and > or = 40 mm Hg), PADP (> 15 mm Hg) and MPAP (> or = 20 mm Hg) were detected in 22, 33, 10, and 23% of subjects, respectively. Peak V E/VCO2 (positive correlation) and peak VO2 (negative correlation) correlated modestly with all pressure measurements (r = 0.33-0.51, P < 0.01 for all measurements). By receiver operating curve analysis, a V E/VCO2 >35.5 exhibited the best diagnostic accuracy with a curve areas of 0.81 for PAP > or = 30 mm Hg (sensitivity/specificity = 86%/67%), 0.87 for PAP > or = 40 mm Hg (77%/100%), 0.86 for MPAP > 20 mm Hg (83%/79%), and 0.84 for PCWP > or = 15 mm Hg (80%/76%). CONCLUSIONS:CPX can accurately identify abnormal resting hemodynamics in patients with NHCM. Further testing of this modality in other forms of diastolic dysfunction may be warranted.

译文

目的:在收缩性心力衰竭患者中,心肺功能测试(CPX)变量反映病理生理的能力已得到充分确立。然而,尚未在非阻塞性肥厚型心肌病(NHCM)患者中彻底研究CPX与病理生理学之间的关系。这项研究的目的是评估CPX变量反映非阻塞性肥厚型心肌病NHCM患者静息血流动力学的能力。
方法:我们对83例NHCM患者(51例男性/ 32例女性,平均年龄= 38/10年,NYHA I-III平均值= 1.7)进行了CPX和右心导管检查。将峰值运动时的峰值耗氧量(O2)和分钟通气/二氧化碳比(VE / VCO2)与静息血液动力学进行比较,包括肺动脉收缩压,舒张压和平均压力(PASP,PADP和MPAP)以及肺毛细血管楔压(PCWP) )。
结果:在22中检测到PCWP(>或= 15 mm Hg),PASP(>或= 30 and>或= 40 mm Hg),PADP(> 15 mm Hg)和MPAP(>或= 20 mm Hg)升高。 ,分别占33%,10%和23%的受试者。峰值V E / VCO2(正相关)和峰值VO2(负相关)与所有压力测量值均呈适度相关(r = 0.33-0.51,所有测量值P <0.01)。通过接收器工作曲线分析,VE / VCO2> 35.5表现出最佳的诊断准确性,PAP>或= 30 mm Hg的曲线面积为0.81(灵敏度/特异性= 86%/ 67%),PAP>或= 40的曲线面积为0.87毫米汞柱(77%/ 100%),MPAP> 20毫米汞柱(83%/ 79%)为0.86,PCWP>或= 15毫米汞柱(80%/ 76%)为0.84。
结论:CPX可以准确识别NHCM患者的异常静息血液动力学。可能需要对其他形式的舒张功能障碍的这种方式进行进一步测试。

+1
+2
100研值 100研值 ¥99课程
检索文献一次
下载文献一次

去下载>

成功解锁2个技能,为你点赞

《SCI写作十大必备语法》
解决你的SCI语法难题!

技能熟练度+1

视频课《玩转文献检索》
让你成为检索达人!

恭喜完成新手挑战

手机微信扫一扫,添加好友领取

免费领《Endnote文献管理工具+教程》

微信扫码, 免费领取

手机登录

获取验证码
登录