冠状动脉临界病变患者心肺运动试验的特点及临床意义

doi:10.3969/j.issn.1006-9771.2022.07.015

《中国康复理论与实践》 ›› 2022, Vol. 28 ›› Issue (7): 833-840.doi: 10.3969/j.issn.1006-9771.2022.07.015

冠状动脉临界病变患者心肺运动试验的特点及临床意义

王国栋^1,²(),唐丽^1,²,刘杰^1,²,林伟^1,²,张焱^1,²,左雪冰^1,²

1.首都医科大学康复医学院,北京市 100068
2.中国康复研究中心北京博爱医院心血管内科,北京市 100068

收稿日期:2022-02-09 修回日期:2022-04-12 出版日期:2022-07-25 发布日期:2022-08-08
通讯作者: 王国栋 E-mail:wangguodong@ccmu.edu.cn
作者简介:王国栋(1972-),男,汉族,山东诸城市人,博士,副主任医师,主要研究方向：冠心病介入诊治、心血管危重症抢救及心脏康复。
基金资助:
中国康复研究中心科研项目(2019ZX-24)

Features of cardiopulmonary exercise test in patients with intermediate coronary stenosis

WANG Guodong^1,²(),TANG Li^1,²,LIU Jie^1,²,LIN Wei^1,²,ZHANG Yan^1,²,ZUO Xuebing^1,²

1. Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China
2. Department of Cardiology, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China

Received:2022-02-09 Revised:2022-04-12 Published:2022-07-25 Online:2022-08-08
Contact: WANG Guodong E-mail:wangguodong@ccmu.edu.cn
Supported by:
China Rehabilitation Research Center Research Project(2019ZX-24)

摘要/Abstract

摘要：

目的回顾性分析冠状动脉临界病变患者心肺运动试验的临床特点和功能能力的变化。

方法回顾分析北京博爱医院2015年1月至2020年1月行冠状动脉造影并同期行心肺运动试验测试的患者,其中冠脉临界病变组184例,非冠心病组73例。比较两组症状、基线资料、实验室和超声心动图数据、心肺运动试验结果,并观察1年内主要心血管事件。

结果与非冠心病组相比,冠脉临界病变组男性比例显著升高(χ² = 15.857, P < 0.001),有吸烟史(χ² = 9.067, P = 0.003)、高血压病史(χ² = 15.087, P < 0.001)、高脂血症病史(χ² = 13.507, P < 0.001)的比例明显升高;糖化血红蛋白(Z = 2.431, P = 0.015)和超敏C-反应蛋白(Z = 2.108, P = 0.035)水平偏高;达到无氧阈比例明显偏低(χ² = 10.702, P = 0.001);无氧阈时的心率和呼吸交换率降低(Z > 2.156, P < 0.05);两组1年后主要心血管事件发生率无显著性差异(P = 1.000)。

结论冠脉临界病变患者心肺功能有所降低,应控制吸烟、高血压、高脂血症、糖尿病等危险因素。

关键词: 冠状动脉临界病变, 心肺运动试验, 心率, 摄氧量, 无氧阈

Abstract:

Objective To review the clinical characteristics and capacity of cardiopulmonary exercise test in patients with intermediate coronary stenosis.

Methods From January, 2015 to January, 2020, the patients underwent coronary angiography and cardiopulmonary exercise test in Beijing Bo'ai Hospital were divided into intermediate coronary stenosis group (n = 184) and non-coronary heart disease group (n = 73). Symptoms, general information, laboratory and echocardiography information, results of cardiopulmonary exercise test were compared between two groups, and the main cardiovascular events during a year were observed.

Results The proportion of male (χ² = 15.857, P < 0.001), smoking history (χ² = 9.067, P= 0.003), hypertension history (χ² = 15.087, P < 0.001) and hyperlipidemia history (χ² = 13.507, P < 0.001) were more, and the level of hemoglobin A1c (Z= 2.431, P= 0.015) and high sensitivity C-reactive protein (Z = 2.108, P = 0.035) were higher in the intermediate coronary stenosis group, while less of them could reach anaerobic threshold (χ² = 10.702, P = 0.001). The heard rate and respiratory exchange rate as anaerobic threshold decreased in the intermediate coronary stenosis group (Z > 2.156, P < 0.05). There was no significant difference in main cardiovascular events between the two groups within a year (P = 1.000).

Conclusion Cardiopulmonary capacity has been impaired in patients with intermediate coronary stenosis, who need to pay attention to the risk factors such as smoking, diabetes mellitus, hypertension and hyperlipidemia.

Key words: intermediate coronary stenosis, cardiopulmonary exercise test, heart rate, oxygen uptake, anaerobic threshold

中图分类号:

R541.4

王国栋,唐丽,刘杰,林伟,张焱,左雪冰. 冠状动脉临界病变患者心肺运动试验的特点及临床意义[J]. 《中国康复理论与实践》, 2022, 28(7): 833-840.

WANG Guodong,TANG Li,LIU Jie,LIN Wei,ZHANG Yan,ZUO Xuebing. Features of cardiopulmonary exercise test in patients with intermediate coronary stenosis[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(7): 833-840.

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参考文献 30

[1]	RZECZUCH K, SZAJN G, JANKOWSKA E, et al. Borderline coronary lesions may lead to serious coronary events: long-term outcome in 65 conservatively treated patients[J]. Kardiol Pol, 2005, 63(7): 50-56;

[2]	AHN S G, LEE S J. Dose coronary angiography suffice for assessment of intermediate coronary stenosis?[J]. Korean Circ J, 2019, 49 (11): 1033-1034. doi: 10.4070/kcj.2019.0227
[3]	KIM J H, CHOI W, KIM K C, et al. The current status of intervention for intermediate coronary stenosis in the Korean Percutaneous Coronary Intervention (K-PCI) Registry[J]. Korean Circ J, 2019, 49(11): 1022-1032. doi: 10.4070/kcj.2019.0074
[4]	LEE J G, KO J, HAE H, et al. Intravascular ultrasound-based machine learning for predicting fractional flow reserve in intermediate coronary artery lesions[J]. Atherosclerosis, 2020, 292: 171-177. doi: 10.1016/j.atherosclerosis.2019.10.022
[5]	中华医学会心血管病学分会介入心脏病学组, 心管病影像学组. 光学相干断层成像技术在冠心病介入诊疗领域的应用中国专家建议[J]. 中华心血管病杂志, 2017, 45(1): 5-12.
	Interventional Cardiology Group of Cardiovascular Branch of Chinese Medical Association, Cardiovascular Imaging Group. Chin J Cardiol, 2017, 45(1): 5-12.
[6]	BHATT H, DAYANAND S, CASTELLANOS J M, et al. Utility of imaging modalities in coronary lesions with borderline fractional flow reserve[J]. Cardiovasc Revasc Med, 2020, 21(11): 1405-1410. doi: 10.1016/j.carrev.2020.04.018
[7]	PINKSTAFF S O, BURGER C D, DAUGHERTY J, et al. Cardiopulmonary exercise testing in patients with pulmonary hypertension: clinical recommendations based on a review of the evidence[J]. Expert Rev Respir Med, 2016, 10(3): 279-295. doi: 10.1586/17476348.2016.1144475
[8]	何东方, 刘梅颜, 张丽军, 等. 冠状动脉中度狭窄伴胸痛患者的冠状动脉微循环阻力状况及其相关因素分析[J]. 中华内科杂志, 2018, 57(4): 270-274.
	HE D F, LIU M Y, ZHANG L J, et al. Coronary microvascular resistance and its relevant factors in patients with moderate coronary stenosis and chest pain[J]. Chin J Internal Med, 2018, 57(4): 270-274.
[9]	CAMICI P G, D'AMATI G, RIMOLDI O. Coronary microvascular dysfunction: mechanisms and functional assessment[J]. Nat Rev Cardiol, 2015, 12(1): 48-62. doi: 10.1038/nrcardio.2014.160
[10]	郑翔, 潘娜娜, 谭丽娟. 冠状动脉临界病变患者药物治疗后发生远期主要不良心血管事件的影响因素[J]. 岭南心血管病杂志, 2020, 3(26): 253-257.
	ZHENG X, PAN N N, TAN L J. Influencing factors for long-term major adverse cardiovascular events in patients with coronary borderline lesion after medical treatment[J]. South Chin J Cardiovasc Dis, 2020, 3(26): 253-257.
[11]	PEIKERT A, KAIER K, MERZ J, et al. Residual inflammatory risk in coronary heart disease: incidence of elevated high-sensitive CRP in a real-world cohort[J]. Clin Res Cardiol, 2020, 109(3): 315-323. doi: 10.1007/s00392-019-01511-0
[12]	LI H, SUN K, ZHAO R, et al. Inflammatory biomarkers of coronary heart disease[J]. Front Biosci (Schol Ed), 2018, 10(1): 185-196. doi: 10.2741/s508
[13]	HERDY A H, RITT L E, STEIN R, et al. Cardiopulmonary exercise test: background, applicability and interpretation[J]. Arq Bras Cardiol, 2016, 107(5): 467-481.
[14]	TRACHSEL L D, BOIDIN M, HENRI C, et al. Women and men with coronary heart disease respond similarly to different aerobic exercise training modalities: a pooled analysis of prospective randomized trials[J]. Appl Physiol Nutr Metab, 2021, 46(5): 417-425. doi: 10.1139/apnm-2020-0650
[15]	ARENA R, MYERS J, KAMINSKY L A. Revisiting age-predicted maximal heart rate: Can it be used as a valid measure of effort?[J]. Am Heart J, 2016, 173: 49-56. doi: 10.1016/j.ahj.2015.12.006
[16]	ROSS R M. ATS/ACCP statement on cardiopulmonary exercise testing[J]. Am J Respir Crit Care Med, 2003, 167 (10): 1451.
[17]	ROSS R, BLAIR S N, ARENA R, et al. Importance of assessing cardiorespiratory fitness in clinical practice: a case for fitness as a clinical vital sign: a scientific statement from the American Heart Association[J]. Circulation, 2016, 134(24): e653-e699.
[18]	POPOVIC D, MARTIC D, DJORDJEVIC T, et al. Oxygen consumption and carbon-dioxide recovery kinetics in the prediction of coronary artery disease severity and outcome[J]. Int J Cardiol, 2017, 248: 39-45. doi: 10.1016/j.ijcard.2017.06.107
[19]	朱珊雨, 王曦, 孙兴国. 心肺运动试验用于冠心病诊断价值的临床研究[J]. 中国应用生理学杂志, 2021, 37(1): 72-78.
	ZHU S Y, WANG X, SUN X G. Clinical study on the diagnostic value of cardiopulmonary exercise test for coronary atherosclerotic heart disease[J]. Chin J Appl Physiol, 2021, 37(1): 72-78.
[20]	AKINCI ÖZYÜREK B, SAVAŞ BOZBAŞ Ş, AYDINALP A, et al. Value of cardiopulmonary exercise testing in the diagnosis of coronary artery disease[J]. Tuberk Toraks, 2019, 67(2): 102-107. doi: 10.5578/tt.68200
[21]	KAMINSKY L A, ARENA R, MYERS J, et al. Updated reference standards for cardiorespiratory fitness measured with cardiopulmonary exercise testing: data from the Fitness Registry and the Importance of Exercise National Database (FRIEND)[J]. Mayo Clin Proc, 2022, 97(2): 285-293. doi: 10.1016/j.mayocp.2021.08.020
[22]	慈政, 孙兴国, 代雅琪, 等. 心肺运动试验终止指征:峰值呼吸交换率值的探讨[J]. 中国全科医学, 2018, 21(30): 3680-3686. doi: 10.12114/j.issn.1007-9572.2018.00.252
	CI Z, SUN X G, DAI Y Q, et al. Can peak respiratory exchange ratio be used as a predictor for stopping symptom-limited maximal cardiopulmonary exercise testing?[J]. Chin Gener Prac, 2018, 21(30): 3680-3686. doi: 10.12114/j.issn.1007-9572.2018.00.252
[23]	张也, 孙兴国, 刘方, 等. Max试验验证症状限制心肺运动试验为最大极限运动进一步临床研究[J]. 中国应用生理学杂志, 2021, 37(2): 147-153.
	ZHANG Y, SUN X G, LIU F, et al. Max test verify further clinical research for whether individualized symptom-limited cardiopulmonary exercise testing is the maximum extreme exercise[J]. Chin J Appl Physiol, 2021, 37 (2): 147-153.
[24]	TANAKA S, NODA T, SEGAWA T, et al. Relationship between functional exercise capacity and functional stenosis in patients with stable angina and intermediate coronary stenosis[J]. Circul J, 2009, 73(12): 2308-2314. doi: 10.1253/circj.CJ-09-0250
[25]	YU D Q, LIN S G, ZHOU Y L, et al. Vulnerable plaque burden post pharmacological and interventional treatments in patients with acute coronary syndrome and borderline lesion: intravascular ultrasound follow up results[J]. Chin J Cardiovasc Dis, 2011, 39(2): 137-141.
[26]	SEO Y H, KIM Y K, SONG I G, et al. Long-term clinical outcomes in patients with untreated non-culprit intermediate coronary lesion and evaluation of predictors by using virtual histology-intravascular ultrasound; a prospective cohort study[J]. BMC Cardiovasc Disord, 2019, 19(1): 187. doi: 10.1186/s12872-019-1173-5
[27]	BAE J H, CORBAN M T, SEO Y H, et al. Ten-year clinical outcomes of an intermediate coronary lesion; prognosis and predictors of major adverse cardiovascular events[J]. Int J Cardiol, 2020, 299: 26-30. doi: 10.1016/j.ijcard.2019.06.076
[28]	MARON D J, HOCHMAN J S, REYNOLDS H R, et al. Initial invasive or conservative strategy for stable coronary disease[J]. N Engl J Med, 2020, 382(15): 1395-1407. doi: 10.1056/NEJMoa1915922
[29]	AL-LAMEE R, THOMPSON D, DEHBI H M, et al. Percutaneous Coronary Intervention in Stable Angina (ORBITA): a double-blind, randomised controlled trial[J]. Lancet, 2018, 391(10115): 31-40. doi: 10.1016/S0140-6736(17)32714-9
[30]	ZIMMERMANN F M, FERRARA A, JOHNSON N P, et al. Deferral vs. performance of percutaneous coronary intervention of functionally non-significant coronary stenosis: 15-year follow-up of the DEFER trial[J]. Eur Heart J, 2015, 36(45): 3182-3188. doi: 10.1093/eurheartj/ehv452

项目	非冠心病组 (n = 73)	临界病变组 (n = 184)	χ²/t值	P值
性别(男/女)/n	20/53	101/83	15.857	< 0.001
年龄/岁	61.21±7.46	62.94±7.9	1.612	0.108
BMI/kg·m^-2	25.79±3.42	26.41±3.14	1.399	0.163
吸烟史/n	17	80	9.067	0.003
饮酒史/n	12	48	2.719	0.099
高血压史/n	35	135	15.087	< 0.001
糖尿病史/n	16	63	3.727	0.054
高脂血症史/n	37	137	13.507	< 0.001

主诉	非冠心病组 (n = 73)	临界病变组 (n = 184)	χ²值	P值
胸背痛^a	45	101	0.971	0.324
呼吸困难^a	23	68	0.679	0.410
心悸^b	1	4	0	1.000
晕厥^c	1	2		1.000
其他不典型症状^b	3	9	0	1.000

项目	非冠心病组 (n = 73)	临界病变组 (n = 184)	Z/t值	P值
HBA₁C/%	5.9(5.60, 6.36)	6.2(5.73, 7.05)	2.431	0.015
LDL-C/mmol·L^-1	2.48(1.96, 3.18)	2.42(1.99, 3.21)	0.223	0.823
WBC/10⁹·L^-1	6.13±1.57	6.26±1.67	0.568	0.571
hsCRP/mg·dL^-1	0.1(0.04, 0.24)	0.16(0.06, 0.39)	2.108	0.035
EF/%	66(62, 70)	65.1(62, 69)	0.914	0.361

项目	非冠心病组 (n = 73)		χ²值	P值
终止原因			0.000	0.989
ST改变	56	141
其他	17	43
强度达到无氧阈	69	142	10.702	0.001
结果			0.939	0.332
阳性	38	108
阴性	35	76

项目	非冠心病组(n = 73)	临界病变组(n = 184)	t/Z值	P值
静息心率/min^-1	70(64.5, 75)	68(63, 74)	1.233	0.218
峰值心率/min^-1	123.6±18.3	117.1±17.1	2.705	0.007
峰值心率/%pred	77(69, 85)	73(67, 81)	2.087	0.037
无氧阈心率/min^-1	99(89.5, 106.5)	92.5(71, 102)	3.283	0.001
峰值功率/W	88.2±24.2	89.2±35.2	0.208	0.835
最大通气量/L	40(33.5, 49)	41(32, 53)	0.351	0.726
无氧阈摄氧量/ml·min^-1	789(622.7, 905)	778.5(481, 986.3)	0.359	0.719
VO_2max/ml·min^-1	1148(996, 1325.5)	1159(920.5, 1433)	0.315	0.752
单位体质量VO_2peak/ml·min^-1·kg^-1	17.49±3.6	16.8±4.4	1.170	0.243
无氧阈单位体质量摄氧量/ml·min^-1·kg^-1	11.4(9.3, 13.9)	11.05(6.95, 13.5)	1.659	0.097
VO_2peak/%pred	79(69.5, 89)	70.5(62, 82)	3.147	0.002
峰值CO₂排出量/ml·min^-1	1289.2±351.2	1297.5±470.3	0.136	0.892
无氧阈CO₂通气当量	29.5(27.05, 32.1)	28.9(24.4, 31.95)	1.781	0.075
峰值RER	1.1(1.03, 1.17)	1.09(1.01, 1.16)	0.919	0.358
无氧阈RER	0.9(0.86, 0.98)	0.89(0.78, 0.96)	2.156	0.031
METs	5.01±1.02	4.82±1.22	1.181	0.239

冠状动脉临界病变患者心肺运动试验的特点及临床意义

Features of cardiopulmonary exercise test in patients with intermediate coronary stenosis

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变量	B	SE	β	P值
常量	135.149	6.764		< 0.001
性别	-3.875	3.251	-0.106	0.234
高血压史	-1.577	2.555	-0.041	0.538
高脂血症史	-5.647	2.576	-0.145	0.029
吸烟史	-5.150	3.298	-0.137	0.120
冠脉造影结果	-2.194	1.332	-0.108	0.101

变量	B	SE	β	P值
常量	86.732	4.159		< 0.001
性别	-3.813	1.999	-0.169	0.058
高血压史	0.084	1.571	0.004	0.957
吸烟史	-5.303	2.028	-0.229	0.009
高脂血症史冠脉造影结果	-3.590 -0.878	1.584 0.819	-0.149 -0.070	0.024 0.285

变量	B	SE	β	P值
常量	117.406	14.808		< 0.001
性别	-11.342	7.116	-0.141	0.112
高血压史	7.154	5.593	0.084	0.202
高脂血症史	-10.642	5.639	-0.124	0.060
吸烟史	-6.188	7.220	-0.074	0.392
冠脉造影结果	-9.944	2.915	-0.223	0.001

变量	B	SE	β	P值
常量	-1738.467	515.878		0.001
性别	-105.934	57.159	-0.160	0.065
身高	1920.663	279.456	0.490	< 0.001
高血压史	48.274	37.477	0.069	0.199
吸烟史	3.734	48.494	0.005	0.939
高脂血症史冠脉造影结果	-69.397 -20.160	37.760 19.551	-0.098 -0.055	0.067 0.303

变量	B	SE	β	P值
常量	72.668	28.847		0.012
性别	8.818	3.196	0.279	0.006
身高	-5.070	15.626	-0.027	0.746
高血压史	1.883	2.096	0.056	0.370
吸烟史	-2.170	2.712	-0.067	0.424
高脂血症史冠脉造影结果	-1.823 -1.769	2.111 1.093	-0.054 -0.101	0.389 0.107

变量	B	SE	β	P值
常量	-2506.941	710.703		< 0.001
性别	-14.673	78.745	-0.018	0.852
身高	2035.722	384.995	0.431	< 0.001
高血压史	91.692	51.631	0.109	0.077
吸烟史	-40.703	66.809	-0.050	0.543
高脂血症史冠脉造影结果	-80.888 -59.954	52.020 26.934	-0.095 -0.136	0.121 0.027

变量	B	SE	β	P值
常量	0.676	0.210		0.001
性别	-0.004	0.023	-0.018	0.864
身高	0.273	0.114	0.212	0.017
高血压史	-0.003	0.015	-0.012	0.857
吸烟史	-0.007	0.020	-0.032	0.718
高脂血症史冠脉造影结果	-0.019 -0.010	0.015 0.008	-0.083 -0.080	0.209 0.226

变量	B	SE	β	P值
常量	-0.779	0.685		0.257
性别	-0.003	0.076	-0.004	0.967
身高	1.043	0.371	0.242	0.005
高血压史	0.063	0.050	0.082	0.205
吸烟史	-0.059	0.064	-0.078	0.364
高脂血症史冠脉造影结果	-0.075 -0.090	0.050 0.026	-0.096 -0.224	0.139 0.001

变量	B	SE	β	P值
常量	13.543	0.922		< 0.001
年龄	-0.061	0.008	-0.411	< 0.001
性别	-1.231	0.187	-0.527	< 0.001
体质量	-0.039	0.006	-0.369	< 0.001
高血压史	0.121	0.142	0.049	0.396
吸烟史	-0.157	0.183	-0.065	0.392
高脂血症史冠脉造影结果	-0.123 -0.124	0.142 0.073	-0.049 -0.096	0.387 0.092

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[11]	李寿霖,a，张焱,a，刘杰,a，杨威,a，刘立君,a，郑志昌,a，林伟,a，王晓荣,a，王国栋,a，封丽红,a，陈思远,a，杨祖福,b. 选择性β1受体阻滞剂对高血压患者运动耐力的影响[J]. 《中国康复理论与实践》, 2017, 23(4): 446-448.
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