CPET 评价冠状动脉粥样硬化性 心脏病患者的临床意义

Significance of cardiopulmonary exercise test in evaluation of patients with coronary heart disease

摘要:

目的 探讨冠状动脉粥样硬化性心脏病（以下简称冠心病）对患者静息态及运动后的心脏功能 的影响，心肺运动试验（CPET）对冠心病患者的评价意义。方法 将243 例行CPET 患者分为冠心病组及对 照组，比较分析患者的一般资料、超声心动图、CPET 资料及合并疾病、冠心病病史和病变情况。结果 两 组患者左室射血分数（LVEF）比较无差异（P >0.05），冠心病组峰值摄氧量低于对照组（P <0.05），冠心病组 峰值摄氧量占预计值的百分比低于对照组（P <0.05）。结论 冠心病对患者运动后心脏储备功能的损伤早于 对静息态LVEF 的影响，建议对冠心病患者行CPET 并对运动后心脏储备功能进行评价。

Abstract:

Objective To explore the effect of coronary heart disease (CHD) on cardiac function of patients in resting state and after exercises and evaluate the significance of cardiopulmonary exercise test (CPET) in patients with CHD. Methods In this study 243 patients who underwent CPET were studied and divided into two groups according to coronary angiogram, i.e. a CHD group (n = 174) and a control group (n = 69). Clinical manifestations, combined diseases, CHD situations, ultrasonic cardiogram and CPET data of the patients were collected and analyzed. Results The left ventricular ejection fraction (LVEF) had no significant difference between the CHD group and the control group (P > 0.05). The peak oxygen consumption (VO2peak) in the CHD group was lower than that in the control group (P < 0.05). The VO2peak% in the CHD group was declined and significant lower than that in the control group (P < 0.05). The differences still existed after controlling the confounding effects of age, gender, smoking, hypertension, diabetes mellitus via convariance analysis. Conclusions The damage of CHD to cardiac reserve function after exercise is earlier than that to LVEF in resting condition. CPET should be performed to evaluate the cardiac reserve function in the patients with coronary heart disease.