Size, Shape, and Stamina The Impact of Left Ventricular Geometry on Exercise Capacity
Size, Shape, and Stamina The Impact of Left Ventricular Geometry on Exercise Capacity
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DOI：
10.1161/hypertensionaha.109.146845
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发表时间：
2010-05-01
期刊：
影响因子：
8.3
通讯作者：
Pellikka, Patricia A.
中科院分区：
文献类型：
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作者：
Lam, Carolyn S. P.;Grewal, Jasmine;Pellikka, Patricia A.
尽管有几项研究研究了运动能力的心脏功能决定因素，但很少有人研究结构重塑的影响。目前的研究评估了心脏几何形状和运动能力之间的联系。射血分数<50%且无瓣膜疾病、心肌缺血或心律失常的受试者来自一个大型的运动超声心动图数据库。根据左心室质量指数和相对室壁厚度将几何构型分为正常、向心性重构、偏心性肥厚和向心性肥厚。所有受试者均按标准Bruce方案进行症状受限的平板运动。最大运动耐量是用代谢当量来衡量的。在366例(60~14岁，男性57%)受试者中，正常几何构型166例(45%)，向心性重构106例(29%)，离心性肥厚40例(11%)，向心性肥厚54例(15%)。几何构型与运动能力相关：正常组最大代谢当量为9.9+/-2.8，向心性肥厚组为8.9+/-2.6，离心性肥厚组为8.6+/-3.1，向心性肥厚组为8.0+/-2.7(P
Although several studies have examined the cardiac functional determinants of exercise capacity, few have investigated the effects of structural remodeling. The current study evaluated the association between cardiac geometry and exercise capacity. Subjects with ejection fraction >= 50% and no valvular disease, myocardial ischemia, or arrhythmias were identified from a large prospective exercise echocardiography database. Left ventricular mass index and relative wall thickness were used to classify geometry into normal, concentric remodeling, eccentric hypertrophy, and concentric hypertrophy. All of the subjects underwent symptom-limited treadmill exercise according to standard Bruce protocol. Maximal exercise tolerance was measured in metabolic equivalents. Of 366 (60 14 years; 57% male) subjects, 166 (45%) had normal geometry, 106 (29%) had concentric remodeling, 40 (11%) had eccentric hypertrophy, and 54 (15%) had concentric hypertrophy. Geometry was related to exercise capacity: in descending order, the maximum achieved metabolic equivalents were 9.9 +/- 2.8 in normal, 8.9 +/- 2.6 in concentric remodeling, 8.6 +/- 3.1 in eccentric hypertrophy, and 8.0 +/- 2.7 in concentric hypertrophy (all P