运动试验时心脏变时功能不全影响因素的研究

目的分析平板运动试验中心脏变时功能不全的影响因素。方法回顾分析2008年1月至2011年10月于北京大学人民医院行平板运动试验并通过冠状动脉造影明确或排除冠心病的112例患者资料,根据平板运动试验中是否发生心脏变时功能不全(平板运动试验中实测最大心率<85%年龄预测最大心率)将患者分为变时功能正常组(65例)及变时性功能不全组(47例)。收集各项临床观察指标进行Logistic多因素回归分析,探寻平板运动中发生心脏变时功能不全的影响因素。结果单因素分析发现男性(p=0.016)、吸烟(p<0.001)、冠心病(p=0.004)、BM(Ip=0.047)在心脏变时功能不全组间和心脏变时功能正常组两组间存在显著性差异。二分类非条件Logistic多因素回归分析表明,吸烟(OR=3.473;95%CI1.510-7.988;p=0.003)是平板运动试验中心脏变时功能不全的独立危险因素。结论吸烟影响心脏变时功能,是平板运动试验中心脏变时功能不全发生的独立危险因素。

Influcncing factors of chronotropic incompetence during treadmill exercise test

Objective To investigate the effects to cardiac chronotropic incompetence during treadmill exercise test(TET). Methods A retrospective analysis of clinical data, coronary angiography and treadmill exercise test results on 112 patients enrolled from January 2008 to October 2011. All patients were divided into two groups: normal chronotropic function group(n=65) and chronotropic incompetence group(n=47). Cardiac chronotropic incompetence was defined as maximal heart rate fails to reach an arbitrary percentage of 85% of the age-predicted maximal HR(APMHR). Influencing factors of cardiac chronotropic incompetence were explored by multivariate logistic regression analysis. Results ①Univariate analysis showed that there were statistical significant difference of smoking(p<0.001), coronary heart disease (p=0.004), gender (p=0.016), and BMI(p=0.047) between the two groups. ②Multivariate logistic regression analysis further showed that: smoking(OR=3.473, 95%CI 1.510-7.988, p=0.003) is an independent influencing factor of cardiac chronotropic incompetence during treadmill exercise test. Conclusion Smoking influences the cardiac chronotropic function, and it is an independent influencing factor of cardiac chronotropic incompetence during treadmill exercise test.