CAJ | 학술논문

目的评价心房颤动患者二尖瓣舒张早期血流峰速度(E)与二尖瓣环舒张早期运动峰速度(Em)之比(E/Em)和运动耐量的关系.方法连续纳入2011年12月至2013年6月于北京大学第三医院心内科就诊、左心室射血分数正常的非瓣膜病心房颤动患者94例,行超声心动图检查及心肺运动试验.根据E/Em将患者分为两组:E/Em正常组(E/Em≤9)(n=57)和E/Em增高组(E/Em ＞9) (n =37),比较两组的运动耐量.用多因素线性回归分析来确定运动耐量的预测因素.结果 E/Em正常组和E/Em增高组分别为57例(60.6％)和37例(39.4％).两组间比较,最大耗氧量/体重[(26±4) ml· min-1·kg-1比(20±4)ml·min-1·kg-1,P＜0.001]、无氧阈/体重[(25±4) ml·min-1·kg-1比(19±5)ml · min-1·kg-1,P＜0.001]和运动持续时间[(7.2±1.3)min比(5.8±1.3)min,P＜0.001],E/Em增高组均显著低于E/Em正常组.多因素回归分析显示,年龄(r=-0.412,P＜0.001)、性别[男性和女性的最大耗氧量分别为(25±5)ml·min-1·kg-1和(21 ±4) ml·min-1·kg-1,P＜0.001]和E/Em(r=-0.535,P＜0.001)与最大耗氧量/体重独立相关.结论 E/Em是心房颤动患者运动耐量的独立预测因素.
목적 평개심방전동환자이첨판서장조기혈류봉속도(E)여이첨판배서장조기운동봉속도(Em)지비(E/Em)화운동내량적관계.방법 련속납입2011년12월지2013년6월우북경대학제삼의원심내과취진、좌심실사혈분수정상적비판막병심방전동환자94례,행초성심동도검사급심폐운동시험.근거E/Em장환자분위량조:E/Em정상조(E/Em≤9)(n=57)화E/Em증고조(E/Em ＞9) (n =37),비교량조적운동내량.용다인소선성회귀분석래학정운동내량적예측인소.결과 E/Em정상조화E/Em증고조분별위57례(60.6％)화37례(39.4％).량조간비교,최대모양량/체중[(26±4) ml· min-1·kg-1비(20±4)ml·min-1·kg-1,P＜0.001]、무양역/체중[(25±4) ml·min-1·kg-1비(19±5)ml · min-1·kg-1,P＜0.001]화운동지속시간[(7.2±1.3)min비(5.8±1.3)min,P＜0.001],E/Em증고조균현저저우E/Em정상조.다인소회귀분석현시,년령(r=-0.412,P＜0.001)、성별[남성화녀성적최대모양량분별위(25±5)ml·min-1·kg-1화(21 ±4) ml·min-1·kg-1,P＜0.001]화E/Em(r=-0.535,P＜0.001)여최대모양량/체중독립상관.결론 E/Em시심방전동환자운동내량적독립예측인소.
Objective To explore the relationship between the ratio of early diastolic transmitral velocity to early diastolic mitral annular velocity (E/Em) and exercise capacity in patients with atrial fibrillation.Methods A total of 94 consecutive patients with non-valvular atrial fibrillation and preserved left ventricular ejection fraction admitted into our department from December 2011 to June 2013 were included.Echocardiography and cardiopulmonary exercise test were performed.According to E/Em,they were divided into two groups of normal E/Em (E/Em ≤ 9) and elevated E/Em (E/Em ＞ 9).The parameters of exercise capacity,including VO2 max/kg,anaerobic threshold/kg (AT/kg) and exercise time duration were compared between two groups.And the determinants of VO2 max/kg were identified by multivariate regression analysis.Results The number of patients was 57(60.6％) with normal E/Em and 37(39.4％) with elevated E/Em.As compared to those with normal E/Em,the patients with elevated E/Em had lower VO2max/kg[(26 ±4) vs (20 ±4) ml · min-1 · kg-1,P＜0.001],lower AT/kg [(25 ±4) vs (19 ±5) ml · min-1 · kg-1,p ＜0.001] and shorter exercise time duration [(7.2 ± 1.3) vs (5.8 ± 1.3) min,P ＜ 0.001].Multivariate regression analysis revealed that three significant variables were independently associated with VO2 max/kg:age (r =-0.412,P＜0.001),gender((25 ±5) and (21 ±4) ml · min-1 · kg 1 for males and females separately,P ＜ 0.001) and E/Em (r =-0.535,P ＜ 0.001).Conclusion E/Em was independently associated with exercise capacity in patients with atrial fibrillation.