肥厚型心肌病患者的心肺功能评估和相关因素研究

目的:探究肥厚型心肌病(HCM)患者的心肺功能评估和相关因素.方法:连续入选2018年4月至2019年8月期间在中国医学科学院阜外医院功能检测中心行心肺运动试验(CPET)的HCM患者129例为HCM组,另选择与HCM组性别、年龄、体重匹配的健康者113例为正常对照组.HCM组和正常对照组均在医生的监督下进行症状限制性...

Assessment of Cardiopulmonary Exercise Capacity in Patients With Hypertrophic Cardiomyopathy

Objectives:This study sought to assess the functional capacity with cardiopulmonary exercise testing(CPET)in patients with hypertrophic cardiomyopathy(HCM),and explored the factors leading to the reduced functional tolerance in HCM patients.Methods:The study sample included consecutive 129 HCM patients who underwent CPET in Fuwai hospital from April 1,2018 to July 31,2019 and complete clinical assessment,including electrocardiography,Holter and echocardiography.One hundred and thirteen healthy age-,gender-and weight-matched volunteers were enrolled as control group.Results:Compared with control group,peak VO₂(P=0.000),AT(P=0.000),O₂P(P=0.001)and peak heart rate(P=0.000)were significantly decreased in HCM group,while VE/VCO₂(P=0.000)was significantly increased in HCM group.Patients in HCM group had a higher peak SBP(P=0.002),DBP(P=0.004),rest HR(P=0.001)and peak HR(P=0.000)as compared to those in control group.Peak VO₂was significantly associated with NYHA functional class(P=0.004),and also significant associated with NT-proBNP(P=0.015).Linear multiple regression analysis showed that the factors independently associated with peak VO₂included age(B=0.000),female(P=0.000),increased QRS voltages(P=0.003),maximal wall thickness(P=0.029)and pulmonary hypertension(P=0.002).Conclusions:CPET can objectively and quantitatively evaluate the cardiopulmonary exercise capacity in patients with HCM.The peak VO₂is independently associated with age,sex,increased QRS voltages,maximal wall thickness and pulmonary hypertension in HCM patients.