冠状动脉临界病变患者心肺能力与运动后心率恢复的相关性

doi:10.3969/j.issn.1006-9771.2025.07.011

Abstract

Abstract:

Objective To investigate the characteristics and correlation between peak oxygen uptake (VO₂peak) and heart rate recovery (HRR) during cardiopulmonary exercise test (CPET) in patients with coronary borderline lesions.

Methods From January, 2022 to January, 2024, 183 patients with coronary borderline lesions in Beijing Bo'ai Hospital were divided into low cardiorespiratory fitness (LCF) group (n = 61), moderate cardiorespiratory fitness (MCF) group (n = 62) and high cardiorespiratory fitness (HCF) group (n = 60) based on VO₂peak. Their characteristics and CPET parameters including VO₂peak, exercise-phase heart rate (HR1, HR2, HR3), and post-exercise heart rate recovery (HRR1, HRR2, HRR3) were analyzed.

Results After adjusting for age and body mass index, analysis of covariance showed that the peak heart rate, HR1, HR2 and HR3 were the lowest in LCF group (F > 5.388, P < 0.01). Repeated-measures analysis of variance showed that the inter- and intra-group effects were significant in HRR (F > 14.561, P < 0.001). Partial correlation analysis showed that VO₂peak positively correlated with HRR1 (r= 0.404, P< 0.001), HRR2 (r = 0.379, P < 0.001) and HRR3 (r= 0.425, P < 0.001).

Conclusion In patients with coronary artery borderline lesions, VO₂peak demonstrated a significant inverse correlation with HRR, the lower the VO₂peak, the more delays of HRR.

Key words: coronary borderline lesions, heart rate recovery, peak oxygen uptake, cardiopulmonary exercise test, cardiopulmonary capacity

CLC Number:

R541.4

TANG Li, GE Xiaozhen, LIU Jie, ZHANG Yan, WANG Jingrong, ZUO Xuebing, WANG Guodong. Correlation between cardiopulmonary capacity and heart rate recovery after exercise in patients with coronary borderline lesions[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(7): 838-845.

Figures/Tables 7

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References 35

[1]	PATEL M R, BAILEY S R, BONOW R O, et al. ACCF/SCAI/AATS/AHA/ASE/ASNC/HFSA/HRS/SCCM/SCCT/SCMR/STS 2012 Appropriate Use Criteria For Diagnostic Catheterization: American College of Cardiology Foundation Appropriate Use Criteria Task Force Society for Cardiovascular Angiography and Interventions American Association for Thoracic Surgery American Heart Association, American Society of Echocardiography American Society of Nuclear Cardiology Heart Failure Society of America Heart Rhythm Society, Society of Critical Care Medicine Society of Cardiovascular Computed Tomography Society for Cardiovascular Magnetic Resonance Society of Thoracic Surgeons[J]. Catheter Cardiovasc Interv, 2012, 80 (3): E50-E81.
[2]	SOOS M P, GONZALEZ-MORALES D, MCCOMB D. Instantaneous wave-free ratio[M]. Treasure Island, FL: StatPearls Publishing, 2022.
[3]	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.
[4]	BROWN T M, PACK Q R, ABEREGG E, et al. Core components of cardiac rehabilitation programs: 2024 update: a scientific statement from the American Heart Association and the American Association of Cardiovascular and Pulmonary Rehabilitation[J]. Circulation, 2024, 150 (18): e328-e347.
[5]	YONETSU T, HOSHINO M, LEE T, et al. Impact of sex difference on the discordance of revascularization decision making between fractional flow reserve and diastolic pressure ratio during the wave-free period[J]. J Am Heart Assoc, 2020, 9(5): e014790.
[6]	BURZOTTA F, LEONE A M, AURIGEMMA C, et al. Fractional flow reserve or optical coherence tomography to guide management of angiographically intermediate coronary stenosis: a single-center trial[J]. JACC Cardiovasc Interv, 2020, 13(1): 49-58.
[7]	VRINTS C, ANDREOTTI F, KOSKINAS K C, et al. 2024 ESC Guidelines for the management of chronic coronary syndromes[J]. Eur Heart J, 2024, 45(36): 3415-3537. doi: 10.1093/eurheartj/ehae177 pmid: 39210710
[8]	KOBAYASHI Y, COLLET C, ACHENBACH S, et al. Diagnostic performance of angiography-based fractional flow reserve by patient and lesion characteristics[J]. EuroIntervention, 2021, 17(4): e294-e300.
[9]	SCOCCIA A, TOMANIAK M, NELEMAN T, et al. Angiography-based fractional flow reserve: state of the art[J]. Curr Cardiol Rep, 2022, 24(6): 667-678. doi: 10.1007/s11886-022-01687-4 pmid: 35435570
[10]	SUD M, HAN L, KOH M, et al. Association between adherence to fractional flow reserve treatment thresholds and major adverse cardiac events in patients with coronary artery disease[J]. JAMA, 2020, 324(23): 2406-2414.
[11]	KEDHI E, BERTA B, ROLEDER T, et al. Thin-cap fibroatheroma predicts clinical events in diabetic patients with normal fractional flow reserve: the COMBINE OCT-FFR trial[J]. Eur Heart J, 2021, 42(45): 4671-4679.
[12]	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.
[13]	王浩彦. 心肺运动试验简介[J]. 心肺血管病杂志, 2011, 30(2): 162.
	WANG H Y. Cardiopulmonary exercise testing[J]. J Cardiovasc Pulmonar Dis, 2011, 30 (2): 162.
[14]	Correction to: 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines[J]. Circulation, 2020, 141(4): e59.
[15]	KWAŚNIEWSKA M, KOSTKA T, JEGIER A, et al. Regular physical activity and cardiovascular biomarkers in prevention of atherosclerosis in men: a 25-year prospective cohort study[J]. BMC Cardiovasc Disord, 2016, 16: 65.
[16]	GUPTA R, KIM C, AGARWAL N, et al. In Reply to the Letter to the Editor, "Influence of Parkinsonism on Hitler's Decision-Making"[J]. World Neurosurg, 2016, 86: 5. doi: 10.1016/j.wneu.2015.10.026 pmid: 26856784
[17]	DEWAR A, KASS L, STEPHENS R C M, et al. Heart rate recovery assessed by cardiopulmonary exercise testing in patients with cardiovascular disease: relationship with prognosis[J]. Int J Environ Res Public Health, 2023, 20(6): 4678.
[18]	FACIOLI T P, PHILBOIS S V, GASTALDI A C, et al. Study of heart rate recovery and cardiovascular autonomic modulation in healthy participants after submaximal exercise[J]. Sci Rep, 2021, 11(1): 3620. doi: 10.1038/s41598-021-83071-w pmid: 33574441
[19]	VAN DE VEGTE Y J, VAN DER HARST P, VERWEIJ N. Heart rate recovery 10 seconds after cessation of exercise predicts death[J]. J Am Heart Assoc, 2018, 7(8): e008341.
[20]	MASRI A, GOODMAN A L, BARR T, et al. Predictors of long-term outcomes in asymptomatic patients with severe aortic stenosis and preserved left ventricular systolic function undergoing exercise echocardiography[J]. Circ Cardiovasc Imaging, 2016, 9(7): e004689.
[21]	NELSON M E, REJESKI W J, BLAIR S N, et al. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association[J]. Med Sci Sports Exerc, 2007, 39(8): 1435-1445.
[22]	BENJAMIM C J R, MONTEIRO L R L, PONTES Y M M, et al. Caffeine slows heart rate autonomic recovery following strength exercise in healthy subjects[J]. Rev Port Cardiol (Engl Ed), 2021, 40(6): 399-406.
[23]	SCHLAGINTWEIT J, LAHARNAR N, GLOS M, et al. Effects of sleep fragmentation and partial sleep restriction on heart rate variability during night[J]. Sci Rep, 2023, 13(1): 6202. doi: 10.1038/s41598-023-33013-5 pmid: 37069226
[24]	林岭, 吴文腾, 罗嘉铭, 等. 3种最大摄氧量实验室直接测试方法结果比较、回归分析与应用[J]. 中国运动医学杂志, 2024, 43(1): 29-38.
	LIN L, WU W T, LUO J M, et al. Three laboratory direct test methods for maximal oxygen uptake: comparison, regression analysis and applications[J]. Chin J Sports Med, 2024, 43(1): 29-38.
[25]	ZWEERINK A, VAN DER LINGEN A C J, HANDOKO M L, et al. Chronotropic incompetence in chronic heart failure[J]. Circ Heart Fail, 2018, 11(8): e004969.
[26]	AKYÜZ A, ALPSOY S, AKKOYUN D C, et al. Heart rate recovery may predict the presence of coronary artery disease[J]. Anadolu Kardiyol Derg, 2014, 14(4): 351-356. doi: 10.5152/akd.2014.4824 pmid: 24818624
[27]	CHEN Y, YU Y, ZOU W, et al. Association between cardiac autonomic nervous dysfunction and the severity of coronary lesions in patients with stable coronary artery disease[J]. J Int Med Res, 2018, 46(9): 3729-3740. doi: 10.1177/0300060518778416 pmid: 29936852
[28]	AIJAZ B, SQUIRES R W, THOMAS R J, et al. Predictive value of heart rate recovery and peak oxygen consumption for long-term mortality in patients with coronary heart disease[J]. Am J Cardiol, 2009, 103(12): 1641-1646. doi: 10.1016/j.amjcard.2009.02.013 pmid: 19539069
[29]	MOLINA G E, DA CRUZ C J G, FONTANA K E, et al. Post-exercise heart rate recovery and its speed are associated with cardiac autonomic responsiveness following orthostatic stress test in men[J]. Scand Cardiovasc J, 2021, 55(4): 220-226.
[30]	王国栋, 唐丽, 刘杰, 等. 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. doi: 10.3969/j.issn.1006-9771.2022.07.015
	WANG G D, TANG L, LIU J, et al. Features of cardiopulmonary exercise test in patients with intermediate coronary stenosis[J]. Chin J Rehabil Theory Pract, 2022, 28(7): 833-840.
[31]	JOHNSON N P, GOLDBERGER J J. Prognostic value of late heart rate recovery after treadmill exercise[J]. Am J Cardiol, 2012, 110(1): 45-49. doi: 10.1016/j.amjcard.2012.02.046 pmid: 22463837
[32]	LIPINSKI M J, VETROVEC G W, FROELICHER V F. Importance of the first two minutes of heart rate recovery after exercise treadmill testing in predicting mortality and the presence of coronary artery disease in men[J]. Am J Cardiol, 2004, 93(4): 445-449. pmid: 14969619
[33]	周明成, 洪怡. «美国心肺康复协会(AACVPR)心脏康复指南第六版»关于科学运动与训练的更新要点[J]. 实用心脑肺血管病杂志, 2021, 29(6): 1-6.
	ZHOU M C, HONG Y. Updated essentials of scientific exercise and training in the 6th Edition of the Guidelines for Cardiac Rehabilitation Programs by American Association of Cardiovascular and Pulmonary Rehabilitation[J]. Prac J Cardiac Cerebral Pneumal Vasc Dis, 2021, 29(6): 1-6.
[34]	胡晓雷, 吕航, 余秀明, 等. 正常人运动后心率恢复与性别的关系:单中心研究[J]. 实用心电学杂志, 2021, 30(2): 113-116.
	HU X L, LÜ H, YU X M. et al. Relationship between heart rate recovery and gender in normal people after exercise: a single-center study[J]. J Prac Electrocardiol, 2021, 30(2): 113-116.
[35]	CURRIE K D, DIZONNO V, OH P I, et al. Acute physiological responses to high-intensity interval exercise in patients with coronary artery disease[J]. Eur J Appl Physiol, 2023, 123(4): 737-747.

项目	LCF组(n = 61)	MCF(n = 62)	HCF(n = 60)	χ²/F/Z值	P值
年龄/岁	64.21±6.88	61.50±7.34	60.38±6.00	5.140	0.007
体质量指数/(kg·m^-2)	26.14±3.11	26.17±2.73	24.84±2.81	4.232	0.016
性别(男/女)/n	32/29	36/26	40/20	2.560	0.278
β受体阻滞剂(未服用/服用)/n	32/29	34/28	31/29	0.134	0.935
高血压病史(无/有)/n	22/39	16/46	22/38	2.085	0.354
2型糖尿病病史(无/有)/n	43/18	44/18	45/15	0.371	0.832
高脂血症病史(无/有)/n	15/46	18/44	20/40	1.129	0.570
吸烟史(无/有)/n	33/28	35/27	29/31	0.853	0.654
饮酒史(无/有)/n	42/19	47/15	40/20	1.343	0.511
左室射血分数/%	64.10±9.22	65.65±7.54	66.30±5.45	1.351	0.261
左室舒张末径/mm	46.90±7.15	47.29±5.31	45.67±3.97	1.371	0.256
血红蛋白/(g·L^-1)	141.79±14.34	142.84±14.55	143.25±12.82	0.180	0.837
肌酐/(μmol·L^-1)	67.00 (57.50,80.40)	68.70 (59.70,76.70)	70.20 (62.53,76.65)	0.957	0.623
总胆固醇/(mmol·L^-1)	4.21 (3.61,5.24)	4.21 (3.71,4.89)	4.19 (3.42,5.00)	0.713	0.700
甘油三酯/(mmol·L^-1)	1.40 (1.06,1.96)	1.36 (1.02,1.97)	1.20 (0.82,1.78)	5.371	0.068
低密度脂蛋白/(mmol·L^-1)	2.51 (2.03,3.37)	2.37 (1.92,2.92)	2.58 (2.00,3.25)	1.120	0.570
高密度脂蛋白/(mmol·L^-1)	1.14 (1.03,1.31)	1.19 (0.98,1.38)	1.15 (1.00,1.37)	0.291	0.864
糖化血红蛋白/%	6.10 (5.80,7.10)	6.00 (5.60,6.79)	6.01 (5.62,6.40)	2.250	0.325
血沉/(mm·h^-1)	13.02 (8.00,13.02)	13.02 (8.00,13.02)	11.50 (6.75,13.02)	2.493	0.289

项目	LCF组(n = 61)	MCF(n = 62)	HCF(n = 60)	F/Z值	P值
静息心率/(次·min^-1)	69.69±9.67	68.00±8.45	67.50±7.32	1.095	0.337
峰值心率/(次·min^-1)	109.43±13.49	117.77±13.35	128.87±15.12	29.230	< 0.001
HR1/(次·min^-1)	86.52±12.0	89.84±12.42	95.25±11.89	7.993	< 0.001
HR2/(次·min^-1)	80.57±11.30	83.82±11.58	89.60±11.25	9.749	< 0.001
HR3/(次·min^-1)	78.05±10.64	80.90±10.87	85.51±10.01	7.752	0.001
HRR1/(次·min^-1)	22.90±9.23	27.94±9.37	33.62±8.72	20.910	< 0.001
HRR2/(次·min^-1)	28.85±10.07	33.95±9.01	39.27±10.25	17.130	< 0.001
HRR3/(次·min^-1)	31.38±9.72	36.87±9.99	43.35±10.59	21.280	< 0.001
静息摄氧量/(mL·min^-1)	268.00 (215.00,314.00)	292.00 (248.25,341.75)	294.00 (238.75,352.50)	5.590	0.061
静息收缩压/mmHg	123.00 (114.00,132.00)	119.00 (109.00,132.00)	123.00 (113.00,137.00)	2.040	0.361

组别	n	静息心率/ (次·min^-1)	无氧阈时心率/(次·min^-1)	峰值心率/ (次·min^-1)	HR1/(次·min^-1)	HR2/(次·min^-1)	HR3/(次·min^-1)
LCF组	61	69.67±9.67	93.03±8.42^a	109.43±13.49^a	86.83±12.00^a	80.57±11.31^a	78.05±10.65^a
MCF组	62	68.00±7.45	92.92±21.37^a	117.77±13.35^b	89.84±12.42^a	83.82±11.58^a	80.90±10.87^a
HCF组	60	67.50±7.32	103.68±14.07^b	128.87±15.19^c	92.25±11.89^b	89.6±11.25^b	85.52±10.01^b
F值		2.770	6.876	20.345	5.568	7.547	5.388
P值		0.065	0.001	< 0.001	0.005	< 0.001	0.005

组别	n	HRR1		HRR2		HRR3
组别	n	均数	标准差	均数	标准差	均数	标准差
LCF组	61	22.90	9.23	28.85	10.07	31.38	9.72
MCF组	62	27.94	9.37	33.95	9.01	36.87	9.98
HCF组	60	33.62	8.72	39.37	10.25	43.35	10.59

项目	平方和	自由度	均方	F值	P值
组别	2182.0	2	1091.0	14.561	< 0.001
时间	6482.0	2	3241.0	43.257	< 0.001
组别×时间	554.4	4	138.6	1.850	0.118

Correlation between cardiopulmonary capacity and heart rate recovery after exercise in patients with coronary borderline lesions

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[11]	DAI Wei;YANG Zu-fu. Cardiopulmonary Exercise Testing and Rehabilitation of Coronary Artery Diseases (review) [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2010, 16(10): 947-949.
[12]	LI Shou-lin;MENG shen;CHEN Si-yuan;et al. Oxygen Uptake Efficiency Slope： A New Index of Cardiopulmonary Functional Reserve for Adults [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2009, 15(07): 668-670.
[13]	XIAO Han;NIE Xiu-hong;REN Kui;et al. Cardiopulmonary Exercise Testing in Evaluation for Patients with Chronic Obstructive Pulmonary Diseases [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2009, 15(05): 419-421.
[14]	CHENG Er-yue;WU Xiu-chun. Observation of outpatient cardiac rehabilitation on 40 patients with coronary artery disease [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2003, 9(08): 487-488.