潮气末氧分压是心脏病患者的一个强有力的预后预测因素。

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging Pub Date : 2023-06-09 DOI:10.1111/cpf.12838

Asami Ogura, Kazuhiro P. Izawa, Hideto Tawa, Masaaki Wada, Masashi Kanai, Ikko Kubo, Ayano Makihara, Ryohei Yoshikawa, Yuichi Matsuda

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引用次数: 0

摘要

背景：心肺运动试验（CPET）变量代表心脏病患者病理中的中心和外周因素以及综合因素。潮末氧分压从静息阈值到无氧阈值的差异（ΔPETO2）可能主要代表外围因素。本研究旨在验证ΔPETO2对心脏病患者主要不良心脑血管事件（MACCE）的预后意义，包括与分钟通气二氧化碳产生关系（VE/VCO2斜率）和峰值摄氧量（VO2）的比较。方法：本回顾性研究共纳入185例接受CPET的心脏病患者。主要终点为3年MACCE。检测ΔPETO2、VE/VCO2斜率和峰值VO2预测MACCE的能力。结果：预测MACCE的最佳截止值为2.0 ΔPETO2为mmHg（曲线下面积AUC]:0.829），VE/VCO2斜率为29.8（AUC:0.734），19.0 ΔPETO2的AUC高于VE/VCO2斜率和峰值VO2。ΔPETO2组的无MACCE生存率显著降低 ≤ 2.0组与ΔPETO2 > 2.0组（44.4%对91.2%，p 2. ≤ 校正年龄和VE/VCO2斜率后，2.0是MACCE的独立预测因子（危险比[HR]，7.28；p 2（人力资源，6.52；p 结论：在心脏病患者中，ΔPETO2是一个独立于VE/VCO2斜率和峰值VO2的MACCE强预测因子。

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End-tidal oxygen partial pressure is a strong prognostic predictive factor in patients with cardiac disease

Background

Cardiopulmonary exercise testing (CPET) variables represent central and peripheral factors and combined factors in the pathology of patients with cardiac disease. The difference in end-tidal oxygen partial pressure from resting to anaerobic threshold (ΔPETO₂) may represent predominantly peripheral factors. This study aimed to verify the prognostic significance of ΔPETO₂ for major adverse cardiac and cerebrovascular events (MACCE) in cardiac patients, including comparison with the minute ventilation–carbon dioxide production relationship (VE/VCO₂ slope), and peak oxygen uptake (VO₂).

Methods

In total, 185 patients with cardiac disease who underwent CPET were consecutively enroled in this retrospective study. The primary endpoint was 3-year MACCE. The ability of ΔPETO₂, VE/VCO₂ slope, and peak VO₂ to predict MACCE was examined.

Results

Optimal cut-off values for predicting MACCE were 2.0 mmHg for ΔPETO₂ (area under the curve [AUC]: 0.829), 29.8 for VE/VCO₂ slope (AUC: 0.734), and 19.0 mL/min/kg for peak VO₂ (AUC: 0.755). The AUC of ΔPETO₂ was higher than those of VE/VCO₂ slope and peak VO₂. The MACCE-free survival rate was significantly lower in the ΔPETO₂ ≤ 2.0 group versus the ΔPETO₂ > 2.0 group (44.4% vs. 91.2%, p < 0.001). ΔPETO₂ ≤ 2.0 was an independent predictor of MACCE after adjustment for age and VE/VCO₂ slope (hazard ratio [HR], 7.28; p < 0.001) and after adjustment for age and peak VO₂ (HR, 6.52; p < 0.001).

Conclusion

ΔPETO₂ was a strong predictor of MACCE independent of and superior to VE/VCO₂ slope and peak VO₂ in patients with cardiac disease.

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来源期刊

Clinical Physiology and Functional Imaging 医学-生理学

CiteScore

3.40

自引率

5.60%

发文量

审稿时长

6-12 weeks

期刊介绍： Clinical Physiology and Functional Imaging publishes reports on clinical and experimental research pertinent to human physiology in health and disease. The scope of the Journal is very broad, covering all aspects of the regulatory system in the cardiovascular, renal and pulmonary systems with special emphasis on methodological aspects. The focus for the journal is, however, work that has potential clinical relevance. The Journal also features review articles on recent front-line research within these fields of interest. Covered by the major abstracting services including Current Contents and Science Citation Index, Clinical Physiology and Functional Imaging plays an important role in providing effective and productive communication among clinical physiologists world-wide.