Estimating equations for cardiopulmonary exercise testing variables in Fontan patients: derivation and validation using a multicenter cross-sectional database.
Estimating equations for cardiopulmonary exercise testing variables in Fontan patients: derivation and validation using a multicenter cross-sectional database.
复制标题
Fontan 患者心肺运动测试变量的估计方程：使用多中心横断面数据库进行推导和验证。
DOI：
10.1007/s00246-014-1020-5
复制
发表时间：
2015
影响因子：
1.6
通讯作者：
Atz,AndrewM
中科院分区：
文献类型：
--
作者：
Butts,RyanJ;Spencer,CarolynT;Jackson,Lanier;Heal,MarthaE;Forbus,Geoffrey;Hulsey,ThomasC;Atz,AndrewM
心肺功能运动试验（CPET）是评估Fontan循环患者的常用方法。计算CPET预测值的公式基于循环正常的儿童。本研究旨在仅基于Fontan循环患者建立CPET变量的预测方程。对在多中心儿科心脏网络Fontan横断面研究中进行CPET的患者进行筛选。使用进行最大试验（RER > 1.1）的患者计算峰值变量方程，并使用无氧阈值（AT）变量方程计算AT已充分计算的患者。每个队列的80%被随机选择以推导预测方程，其余的作为验证队列。对推导队列中的每个CPET变量进行线性回归分析。将所得方程用于计算验证队列中的预测值。在验证队列中使用线性回归比较观察变量与预测变量。411例患者接受CPET，166例进行最大运动试验，317例充分计算AT。峰值CPET变量的预测方程具有良好的性能;峰值VO 2，R2= 0.61;最大功，R2= 0.61;最大O2脉冲，R2= 0.59。AT时CPET变量的方程解释的变异性较小; AT时VO 2，R2= 0.15; AT时做功，R2= 0.39; AT时O2脉搏，R2= 0.34; AT时VE/VCO 2，R2= 0.18; AT时VE/VO 2，R2= 0.14。在验证队列中，只有AT时的VE/VCO 2和VE/VO 2模型的性能显著较差。在常用CPET变量的8个方程中，有6个能够得到验证。峰值变量的方程在解释值的变化方面比AT方程更稳健。
Cardiopulmonary exercise testing (CPET) is a common method of evaluating patients with a Fontan circulation. Equations to calculate predicted CPET values are based on children with normal circulation. This study aims to create predictive equations for CPET variables solely based on patients with Fontan circulation. Patients who performed CPET in the multicenter Pediatric Heart Network Fontan Cross-Sectional Study were screened. Peak variable equations were calculated using patients who performed a maximal test (RER > 1.1) and anaerobic threshold (AT) variable equations on patients where AT was adequately calculated. Eighty percent of each cohort was randomly selected to derive the predictive equation and the remaining served as a validation cohort. Linear regression analysis was performed for each CPET variable within the derivation cohort. The resulting equations were applied to calculate predicted values in the validation cohort. Observed versus predicted variables were compared in the validation cohort using linear regression. 411 patients underwent CPET, 166 performed maximal exercise tests and 317 had adequately calculated AT. Predictive equations for peak CPET variables had good performance; peak VO2,R2= 0.61; maximum work,R2= 0.61; maximum O2pulse,R2= 0.59. The equations for CPET variables at AT explained less of the variability; VO2at AT,R2= 0.15; work at AT,R2= 0.39; O2pulse at AT,R2= 0.34; VE/VCO2at AT,R2= 0.18; VE/VO2at AT,R2= 0.14. Only the models for VE/VCO2and VE/VO2at AT had significantly worse performance in validation cohort. Of the 8 equations for commonly measured CPET variables, six were able to be validated. The equations for peak variables were more robust in explaining variation in values than AT equations.