Correlation of exercise-induced peripheral venous hypertension with exercise intolerance in patients with Fontan circulation
Correlation of exercise-induced peripheral venous hypertension with exercise intolerance in patients with Fontan circulation
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DOI：
10.1017/s1047951121004285
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发表时间：
2021-10-22
影响因子：
1
通讯作者：
Ueda, Hideaki
中科院分区：
文献类型：
--
作者：
Ono, Shin;Yanagi, Sadamitsu;Ueda, Hideaki
由于没有肺下心室，Fontan循环患者的中心静脉压升高。在运动过程中，中心静脉压可能进一步升高，以增加全身心室前负荷和心输出量。我们进行了一项心肺运动试验的单中心前瞻性试验，同时监测与中心静脉压密切相关的外周静脉压。本研究的目的是检验Fontan循环患者运动峰值时外周静脉压与运动能力呈负相关的假设。17例Fontan术后患者在监测外周静脉压的同时进行运动心肺试验。测量峰值摄氧量、心率储备、峰值氧脉搏（除以体表面积）和峰值运动时的外周静脉压。评估了峰值运动时外周静脉压与峰值摄氧量、心率储备和峰值氧脉搏的相关性。峰值运动时外周静脉压与峰值摄氧量（R =-0.66，p < 0.01）、心率储备（R =-0.6，p < 0.05）和峰值氧脉搏（R =-0.48，p < 0.05）呈负相关。丰唐循环患者运动不耐受与运动诱发的外周静脉高压相关峰值摄氧量是评价Fontan循环患者日常生活中充血状态的一个有用指标。
Owing to the absence of a sub-pulmonary ventricle, the central venous pressure rises in patients with Fontan circulation. During exercise, central venous pressure may rise further to increase the systemic ventricular preload and cardiac output. We performed a single-centre prospective trial of cardiopulmonary exercise test while monitoring peripheral venous pressure which strongly correlates with central venous pressure. The objective of this study was to test the hypothesis that peripheral venous pressure at peak exercise inversely correlates with exercise capacity in patients with Fontan circulation. Seventeen patients following Fontan operation performed cardiopulmonary exercise test while monitoring peripheral venous pressure. Peak oxygen uptake, heart rate reserve, peak oxygen pulse (divided by body surface area), and peripheral venous pressure at peak exercise were measured. Correlations of peripheral venous pressure at peak exercise with the peak oxygen uptake, heart rate reserve, and peak oxygen pulse were evaluated. The peripheral venous pressure at peak exercise inversely correlated with the peak oxygen uptake (R = -0.66, p < 0.01), heart rate reserve (R = -0.6, p < 0.05), and peak oxygen pulse (R = -0.48, p < 0.05). Exercise-induced peripheral venous hypertension correlates with exercise intolerance in patients with Fontan circulation. Peak oxygen uptake is a useful index for evaluating the status of congestion in the daily life of patients with Fontan circulation.