先天性心脏病患儿摄氧效率斜率:结构及组效度。

B C Bongers, H J Hulzebos, A C Blank, M van Brussel, T Takken
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引用次数: 40

摘要

目的:氧摄取效率斜率(OUES)已被提出作为一个独立客观的替代峰值摄氧量(VO(2peak)),它不需要最大的运动。本研究的目的是探讨先天性心脏病(CHD)儿童OUES的结构和组效度。方法:31例冠心病患者,其中Fontan修复组16例(平均年龄±SD 11.2±2.7岁),法洛四联症(ToF)手术修复组15例(平均年龄±SD 13.2±3.6岁)完成了症状受限的心肺运动试验。计算三种不同运动强度下体表面积的OUES并归一化:(1)使用100%的运动数据;(2)使用前75%的运动数据;(3)使用达到呼吸阈值(VT)的运动数据。计算患者的峰值摄氧量(VO(2peak))、VT、通气效率(V(E)/VO(2)-斜率)和通气驱动(V(E)/VCO(2)-斜率),并与46例健康儿童(平均年龄±SD 12.2±2.4岁)进行比较。结果:三组在三种不同运动强度下测得的OUES值均无显著差异。此外,与ToF相比,CHD患儿的OUES显着降低,Fontan患者的OUES显着降低。在Fontan和ToF患者中,OUES与VO(2peak)和VT之间存在很强的相关性。讨论:OUES提供了一种有效的测量冠心病儿童心肺健康的方法,它独立于运动强度,与VO(2peak)和VT (construct validity)密切相关。此外,OUES能够区分健康儿童和冠心病儿童,以及Fontan和ToF患者(组效度)。因此,OUES可能是一个有效的、与努力无关的冠心病儿童心肺健康参数。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The oxygen uptake efficiency slope in children with congenital heart disease: construct and group validity.

Objective: The oxygen uptake efficiency slope (OUES) has been proposed as an independent and objective alternative to the peak oxygen uptake (VO(2peak)), which does not require maximal exercise. The aim of this study was to investigate the construct and group validity of the OUES in children with congenital heart disease (CHD).

Methods: Thirty-one patients with CHD, of which 16 patients (mean age ± SD 11.2 ± 2.7 years) with a Fontan repair and 15 patients (mean age ± SD 13.2 ± 3.6 years) with surgical repair of tetralogy of Fallot (ToF) completed a symptom-limited cardiopulmonary exercise test. The OUES was calculated and normalized for body surface area at three different exercise intensities: (1) using 100% of the exercise data; (2) using the first 75% of the exercise data; and (3) using exercise data up to the ventilatory threshold (VT). Furthermore, peak oxygen uptake (VO(2peak)), VT, ventilatory efficiency (V(E)/VO(2)-slope), and ventilatory drive (V(E)/VCO(2)-slope) were calculated and compared with values of 46 healthy children (mean age ± SD 12.2 ± 2.4 years).

Results: In all three groups, the OUES values determined at the three different exercise intensities were not significantly different from each other. Moreover, the OUES was significantly reduced in the children with CHD, with significantly lower values in the Fontan patients compared to ToF. Strong correlations were found between the OUES and both the VO(2peak) and VT in Fontan and ToF patients.

Discussion: The OUES provides a valid measure of cardiopulmonary fitness in children with CHD, which is independent of exercise intensity and strongly correlated with VO(2peak) and VT (construct validity). Furthermore, the OUES is capable of differentiating between healthy children and children with CHD and between Fontan and ToF patients (group validity). Therefore, the OUES may be a valid, effort-independent parameter of cardiopulmonary fitness in children with CHD.

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