Predictors of Exercise Capacity in Patients with Hypertrophic Obstructive Cardiomyopathy.
Predictors of Exercise Capacity in Patients with Hypertrophic Obstructive Cardiomyopathy.
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DOI：
10.3390/jcm7110447
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发表时间：
2018-11-18
影响因子：
3.9
通讯作者：
Olson TP
中科院分区：
文献类型：
--
作者：
Smith JR;Medina-Inojosa JR;Layrisse V;Ommen SR;Olson TP
肥厚性梗阻性心肌病（HOCM）患者表现出受损的峰值运动能力（VO 2 peak）。重要的是，严重降低的VO 2 peak与这些患者的发病率和死亡率增加直接相关。因此，我们试图确定HOCM患者VO 2峰值的临床预测因素。纳入了1995年至2016年期间进行限制性心肺运动试验的HOCM患者进行分析。峰值VO 2报告为绝对峰值VO 2，以体重为索引，并按四分位数进行分析，四分位数1代表最低的VO 2峰值。使用人口统计学特征、临床和生理特征建立逐步回归模型，以确定具有最低VO 2峰值的HOCM患者的预测因子。我们纳入了1177例HOCM患者（年龄：53 ± 14岁; BMI：最低VO 2峰值的显著单变量预测因素包括年龄、女性、纽约健康协会（NYHA）分级、BMI、左心房容积指数、E/e '、E/A、血红蛋白、N末端前B型利钠肽（NT-proBNP）和糖尿病、高血压、中风、心房颤动或冠状动脉疾病史。最低VO 2峰值的独立预测因素包括年龄（OR，CI：1.03，1.02-1.06; p < 0.0001），女性（4.66，2.94-7.47; p = 0.001），有糖尿病史（2.05，1.17-3.60; p = 0.01），BMI（0.94，0.92-0.96; p < 0.0001），左心房容积指数（1.07，1.05-1.21; p = 0.04）、E/e'（1.05，1.01-1.08; p = 0.004）、血红蛋白（0.76，0.65-0.88; p = 0.0004）和NT-proBNP（1.72，1.42-2.11; p < 0.0001）。这些发现表明，人口因素（即，年龄和性别），合并症（例如，糖尿病和肥胖），超声心动图指数，和生物标记物（例如，血红蛋白和NT-proBNP）预测HOCM患者的VO 2峰值严重受损。
Hypertrophic obstructive cardiomyopathy (HOCM) patients exhibit compromised peak exercise capacity (VO2peak). Importantly, severely reduced VO2peak is directly related to increased morbidity and mortality in these patients. Therefore, we sought to determine clinical predictors of VO2peak in HOCM patients. HOCM patients who performed symptom-limited cardiopulmonary exercise testing between 1995 and 2016 were included for analysis. Peak VO2 was reported as absolute peak VO2, indexed to body weight and analyzed as quartiles, with quartile 1 representing the lowest VO2peak. Step-wise regression models using demographic features and clinical and physiologic characteristics were created to determine predictors of HOCM patients with the lowest VO2peak. We included 1177 HOCM patients (age: 53 ± 14 years; BMI: 24 ± 12 kg/m2) with a VO2peak of 18.0 ± 5.6 mL/kg/min. Significant univariate predictors of the lowest VO2peak included age, female sex, New York Health Association (NYHA) class, BMI, left atrial volume index, E/e’, E/A, hemoglobin, N-terminal pro b-type natriuretic peptide (NT-proBNP), and a history of diabetes, hypertension, stroke, atrial fibrillation, or coronary artery disease. Independent predictors of the lowest VO2peak included age (OR, CI: 1.03, 1.02–1.06; p < 0.0001), women (4.66, 2.94–7.47; p = 0.001), a history of diabetes (2.05, 1.17–3.60; p = 0.01), BMI (0.94, 0.92–0.96; p < 0.0001), left atrial volume index (1.07, 1.05–1.21; p = 0.04), E/e’ (1.05, 1.01–1.08; p = 0.004), hemoglobin (0.76, 0.65–0.88; p = 0.0004), and NT-proBNP (1.72, 1.42–2.11; p < 0.0001). These findings demonstrate that demographic factors (i.e., age and sex), comorbidities (e.g., diabetes and obesity), echocardiography indices, and biomarkers (e.g., hemoglobin and NT-proBNP) are predictive of severely compromised VO2peak in HOCM patients.
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影响因子：
39.3
作者：
Elliott, Perry M.;Anastasakis, Aris;Watkins, Hugh
通讯作者：
Watkins, Hugh
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8.2
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Bugger, Heiko;Abel, E. Dale
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Abel, E. Dale
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158.5
作者：
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Maron, BJ
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Wanger, J
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Matsumoto, AY;Arteaga, E;Mady, C
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Mady, C