同时进行运动负荷心脏磁共振和心肺运动测试以阐明有氧运动能力的菲克成分:在血液肿瘤幸存者中进行的可行性和可重复性研究及试点研究。

IF 3.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Justin M Canada, John McCarty, Jennifer H Jordan, Cory R Trankle, Kevin DeCamp, Josh D West, Mary Ann Reynolds, Rachel Myers, Katey Sweat, Virginia McGhee, Ross Arena, Antonio Abbate, W Gregory Hundley
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引用次数: 0

摘要

背景:接受血液系统恶性肿瘤治疗的患者通常会出现运动能力下降和疲劳感增加的情况;然而,这种下降是与心功能异常有关还是与活动时骨骼肌氧萃取功能受损有关,目前尚不清楚。心肺运动测试(CPET)与负荷心脏磁共振(ExeCMR)相结合,可提供一种无创方法来识别心脏功能或骨骼肌氧萃取的异常。本研究旨在确定 ExeCMR + CPET 技术的可行性和可重复性,以测量峰值氧消耗量(VO2)的 Fick 成分,并试验其在出现疲劳的血液肿瘤患者中的鉴别潜力:我们对 16 名接受 ExeCMR 的患者进行了研究,通过同时测量 VO2 来确定运动心脏储备。动静脉氧含量差(a-vO2diff)计算为 VO2/心脏指数(CI)之商。在 7 名健康对照组中评估了峰值 VO2、CI 和 a-vO2diff 测量的重复性。最后,我们测量了患有疲劳症的血液肿瘤幸存者(6 人)的 VO2 峰值的 Fick 决定因素,并将其与年龄/性别匹配的健康对照组(6 人)进行了比较:所有受试者(16 人,100%)均顺利完成研究程序,未发生任何不良事件。该方案在峰值 VO2(类内相关系数 [ICC] = 0.992 [95%CI:0.955-0.999]; P 2diff (ICC = 0.953 [95%CI:0.744-0.992]; P 2 (17.1 [13.5-23.5] vs. 26.0 [19.7-29.5] mL-kg-1-min-1,P = 0.026)和较低的峰值 CI(5.0 [4.7-6.3] vs. 7.4 [7.0-8.8] L-min-1/m2,P = 0.004),而 a-vO2diff (14.4 [11.8-16.9] vs. 13.6 [10.9-15.4] mLO2/dL,P = 0.589)无显著差异:对于接受血液系统恶性肿瘤治疗的患者来说,采用 ExeCMR + CPET 方案对峰值 VO2 Fick 决定因素进行无创测量是可行且可靠的,并可深入了解疲劳患者的运动不耐受机制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Simultaneous exercise stress cardiac magnetic resonance and cardiopulmonary exercise testing to elucidate the Fick components of aerobic exercise capacity: a feasibility and reproducibility study and pilot study in hematologic cancer survivors.

Simultaneous exercise stress cardiac magnetic resonance and cardiopulmonary exercise testing to elucidate the Fick components of aerobic exercise capacity: a feasibility and reproducibility study and pilot study in hematologic cancer survivors.

Simultaneous exercise stress cardiac magnetic resonance and cardiopulmonary exercise testing to elucidate the Fick components of aerobic exercise capacity: a feasibility and reproducibility study and pilot study in hematologic cancer survivors.

Simultaneous exercise stress cardiac magnetic resonance and cardiopulmonary exercise testing to elucidate the Fick components of aerobic exercise capacity: a feasibility and reproducibility study and pilot study in hematologic cancer survivors.

Background: Patients treated for hematologic malignancy often experience reduced exercise capacity and increased fatigue; however whether this reduction is related to cardiac dysfunction or impairment of skeletal muscle oxygen extraction during activity is unknown. Cardiopulmonary exercise testing (CPET) coupled with stress cardiac magnetic resonance (ExeCMR), may provide a noninvasive method to identify the abnormalities of cardiac function or skeletal muscle oxygen extraction. This study was performed to determine the feasibility and reproducibility of a ExeCMR + CPET technique to measure the Fick components of peak oxygen consumption (VO2) and pilot its discriminatory potential in hematologic cancer patients experiencing fatigue.

Methods: We studied 16 individuals undergoing ExeCMR to determine exercise cardiac reserve with simultaneous measures of VO2. The arteriovenous oxygen content difference (a-vO2diff) was calculated as the quotient of VO2/cardiac index (CI). Repeatability in measurements of peak VO2, CI, and a-vO2diff was assessed in seven healthy controls. Finally, we measured the Fick determinants of peak VO2 in hematologic cancer survivors with fatigue (n = 6) and compared them to age/gender-matched healthy controls (n = 6).

Results: Study procedures were successfully completed without any adverse events in all subjects (N = 16, 100%). The protocol demonstrated good-excellent test-retest reproducibility for peak VO2 (intraclass correlation coefficient [ICC] = 0.992 [95%CI:0.955-0.999]; P < 0.001), peak CI (ICC = 0.970 [95%CI:0.838-0.995]; P < 0.001), and a-vO2diff (ICC = 0.953 [95%CI:0.744-0.992]; P < 0.001). Hematologic cancer survivors with fatigue demonstrated a significantly lower peak VO2 (17.1 [13.5-23.5] vs. 26.0 [19.7-29.5] mL·kg-1·min-1, P = 0.026) and lower peak CI (5.0 [4.7-6.3] vs. 7.4 [7.0-8.8] L·min-1/m2, P = 0.004) without a significant difference in a-vO2diff (14.4 [11.8-16.9] vs. 13.6 [10.9-15.4] mLO2/dL, P = 0.589).

Conclusions: Noninvasive measurement of peak VO2 Fick determinants is feasible and reliable with an ExeCMR + CPET protocol in those treated for a hematologic malignancy and may offer insight into the mechanisms of exercise intolerance in those experiencing fatigue.

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来源期刊
Cardio-oncology
Cardio-oncology Medicine-Cardiology and Cardiovascular Medicine
CiteScore
5.00
自引率
3.00%
发文量
17
审稿时长
7 weeks
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