Exercise-induced changes of vital signs in adults with sickle cell disease.
Exercise-induced changes of vital signs in adults with sickle cell disease.
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DOI：
10.1002/ajh.26369
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发表时间：
2021-12-01
影响因子：
12.8
通讯作者：
Nouraie M
中科院分区：
文献类型：
--
作者：
Johnson S;Gordeuk VR;Machado R;Gibbs JSR;Hildesheim M;Little JA;Kato GJ;Gladwin MT;Nouraie M
六分钟步行测试 (6MWT) 已用于镰状细胞病 (SCD) 患者，与三尖瓣返流速度 (TRV) 和血浆 N 末端脑钠肽前体 (NT-pro BNP) 结合使用，以评估患肺动脉高压的风险。运动引起的生命体征变化（VSC）是其他疾病临床结果的预测因子。在本研究中，我们评估了 6MWT VSC 对成人 SCD 患者的预测因素和预后价值。来自 SCD 患者的跨国研究（用西地那非治疗肺动脉高压：walk-PHaSST）的数据用于计算 6MWT VSC。通过多变量分析确定 VSC 的预测因子，并通过 Cox 比例风险法进行生存分析。在 630 名 SCD 成人中，90% 的患者心率增加，77% 的患者收缩压 (SBP) 增加，50% 的患者氧饱和度下降。 TRV（OR = 1.82，P = 0.020）、绝对网织红细胞计数（OR = 1.03，P < 0.001）和血红蛋白（OR = 0.99，P = 0.035）预测 6MWT 期间氧饱和度≥ 3%。在调整分析中，6MWT 期间收缩压的增加与生存率的提高相关（HR=0.3，95%CI：0.1-0.8）。患有 SCD 的成人在 6MWT 期间，心率和血压升高以及氧饱和度降低很常见。 VSC 与贫血和 TRV 标志物相关，可用于风险分层。 6MWT 期间收缩压的任何增加都与生存率的提高相关，并且可能表明患者增加每搏输出量的能力。
The six-minute walk test (6MWT) has been used in patients with sickle cell disease (SCD), in conjunction with tricuspid regurgitant velocity (TRV) and plasma N-terminal pro-brain natriuretic peptide (NT-pro BNP), to assess risk of having pulmonary hypertension. Exercise induced vital signs change (VSC) are predictors of clinical outcomes in other diseases. In this study, we assess the predictors and prognostic value of 6MWT VSC in adult SCD patients. Data from a multinational study of SCD patients (Treatment of Pulmonary Hypertension with Sildenafil: walk-PHaSST) was used to calculate the 6MWT VSC. Predictors of VSC were identified by multivariable analysis and survival analysis was conducted by the Cox proportional hazard method. An increase in heart rate was observed in 90% of the 630 SCD adults, 77% of patients had an increase in systolic blood pressure (SBP) and 50% a decrease in oxygen saturation. TRV (OR = 1.82, P = 0.020), absolute reticulocyte count (OR = 1.03, P < 0.001) and hemoglobin (OR = 0.99, P = 0.035) predicted oxygen desaturation ≥ 3% during the 6MWT. In adjusted analysis, SBP increase during the 6MWT was associated with improved survival (HR=0.3, 95%CI: 0.1–0.8). Increases in heart rate and blood pressure, as well as oxygen desaturation, are common in adults with SCD during the 6MWT. VSC is associated with markers of anemia and TRV and can be used for risk stratification. Any increase in SBP during the 6MWT was associated with improved survival and may be indicative of a patient’s ability to increase stroke volume.
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影响因子：
20.3
作者：
Eaton, William A.;Bunn, H. Franklin
通讯作者：
Bunn, H. Franklin
影响因子：
18.2
作者：
Cahalin, Lawrence P.;Arena, Ross;Guazzi, Marco
通讯作者：
Guazzi, Marco
DOI：
10.1164/rccm.200601-125oc
发表时间：
2006-06-01
影响因子：
24.7
作者：
Klings, Elizabeth S.;Wyszynski, Diego F.;Steinberg, Martin H.
通讯作者：
Steinberg, Martin H.
影响因子：
3.5
作者：
Douwes, Johannes M.;Hegeman, Anneke K.;Berger, Rolf M. F.
通讯作者：
Berger, Rolf M. F.
影响因子：
3.7
作者：
Gladwin, Mark T.;Barst, Robyn J.;Machado, Roberto F.
通讯作者：
Machado, Roberto F.