Physical Therapy Korea (한국전문물리치료학회지)

Korean Research Society of Physical Therapy (한국전문물리치료학회)
권호 표지
DOI QR코드

DOI QR Code

Reliable Prognostic Cardiopulmonary Function Variables in 110 Patients With Acute Ischemic Heart Disease

  • Lee, Jeong Jae (Sports Movement Artificial-Intelligence Robotics Technology (SMART) Institute) ;
  • Park, Chan-hee (Sports Movement Artificial-Intelligence Robotics Technology (SMART) Institute) ;
  • You, Joshua (Sung) Hyun (Sports Movement Artificial-Intelligence Robotics Technology (SMART) Institute)
  • Received : 2022.06.28
  • Accepted : 2022.08.06
  • Published : 2022.08.20
Download PDF
⟨ Previous Next ⟩

Abstract

Background: The oxygen uptake efficiency slope (OUES) is the most important index for accurately measuring cardiopulmonary function in patients with acute ischemic heart disease. However, the relationship between the OUES variables and important cardiopulmonary function parameters remain unelucidated for patients with acute ischemic heart disease, which accounts for the largest proportion of heart disease. Objects: The present cross sectional clinical study aimed to determine the multiple relationships among the cardiopulmonary function variables mentioned above in adults with acute ischemic heart disease. Methods: A convenience sample of 110 adult inpatients with ischemic heart disease (age: 57.4 ± 11.3 y; 95 males, 15 females) was enrolled at the hospital cardiac rehabilitation center. The correlation between the important cardiopulmonary function indicators including peak oxygen uptake (VO2 peak), minute ventilation (VE)/carbon dioxide production (VCO2) slope, heart rate recovery (HRR), and ejection fraction (EF) and OUES was confirmed. Results: This study showed that OUES was highly correlated with VO2 peak, VE/VCO2 slope, and HRR parameters. Conclusion: The OUES can be used as an accurate indicator for cardiopulmonary function. There are other factors that influence aerobic capacity besides EF, so there is no correlation with EF. Effective cardiopulmonary rehabilitation programs can be designed based on OUES during submaximal exercise in patients with acute ischemic heart disease.

Keywords

References

  1. Baba R, Nagashima M, Goto M, Nagano Y, Yokota M, Tauchi N, et al. Oxygen uptake efficiency slope: a new index of cardiorespiratory functional reserve derived from the relation between oxygen uptake and minute ventilation during incremental exercise. J Am Coll Cardiol 1996;28(6):1567-72. https://doi.org/10.1016/S0735-1097(96)00412-3
  2. Arena R, Myers J, Abella J, Peberdy MA, Bensimhon D, Chase P, et al. The ventilatory classification system effectively predicts hospitalization in patients with heart failure. J Cardiopulm Rehabil Prev 2008;28(3):195-8. https://doi.org/10.1097/01.HCR.0000320071.89093.d6
  3. Francis DP, Shamim W, Davies LC, Piepoli MF, Ponikowski P, Anker SD, et al. Cardiopulmonary exercise testing for prognosis in chronic heart failure: continuous and independent prognostic value from VE/VCO2 slope and peak VO2. Eur Heart J 2000;21(2):154-61. https://doi.org/10.1053/euhj.1999.1863
  4. Arena R, Myers J, Aslam SS, Varughese EB, Peberdy MA. Peak VO2 and VE/VCO2 slope in patients with heart failure: a prognostic comparison. Am Heart J 2004;147(2):354-60. https://doi.org/10.1016/j.ahj.2003.07.014
  5. Bard RL, Gillespie BW, Clarke NS, Egan TG, Nicklas JM. Determining the best ventilatory efficiency measure to predict mortality in patients with heart failure. J Heart Lung Transplant 2006;25(5):589-95. https://doi.org/10.1016/j.healun.2005.11.448
  6. Arena R, Guazzi M, Myers J, Chase P, Bensimhon D, Cahalin LP, et al. The prognostic utility of cardiopulmonary exercise testing stands the test of time in patients with heart failure. J Cardiopulm Rehabil Prev 2012;32(4):198-202. https://doi.org/10.1097/HCR.0b013e318259f153
  7. Van Laethem C, Bartunek J, Goethals M, Nellens P, Andries E, Vanderheyden M. Oxygen uptake efficiency slope, a new submaximal parameter in evaluating exercise capacity in chronic heart failure patients. Am Heart J 2005;149(1):175-80. https://doi.org/10.1016/j.ahj.2004.07.004
  8. Van Laethem C, Van de Veire N, De Sutter J, Bartunek J, De Backer G, Goethals M, et al. Prospective evaluation of the oxygen uptake efficiency slope as a submaximal predictor of peak oxygen uptake in aged patients with ischemic heart disease. Am Heart J 2006;152(2):297.e9-15. https://doi.org/10.1016/j.ahj.2006.04.032
  9. Hollenberg M, Tager IB. Oxygen uptake efficiency slope: an index of exercise performance and cardiopulmonary reserve requiring only submaximal exercise. J Am Coll Cardiol 2000;36(1):194-201. https://doi.org/10.1016/S0735-1097(00)00691-4
  10. Cole CR, Blackstone EH, Pashkow FJ, Snader CE, Lauer MS. Heart-rate recovery immediately after exercise as a predictor of mortality. N Engl J Med 1999;341(18):1351-7. https://doi.org/10.1056/NEJM199910283411804
  11. Arena R, Myers J, Hsu L, Peberdy MA, Pinkstaff S, Bensimhon D, et al. The minute ventilation/carbon dioxide production slope is prognostically superior to the oxygen uptake efficiency slope. J Card Fail 2007;13(6):462-9. https://doi.org/10.1016/j.cardfail.2007.03.004
  12. Hasselberg NE, Haugaa KH, Sarvari SI, Gullestad L, Andreassen AK, Smiseth OA, et al. Left ventricular global longitudinal strain is associated with exercise capacity in failing hearts with preserved and reduced ejection fraction. Eur Heart J Cardiovasc Imaging 2015;16(2):217-24. https://doi.org/10.1093/ehjci/jeu277
  13. Rodgers JL, Jones J, Bolleddu SI, Vanthenapalli S, Rodgers LE, Shah K, et al. Cardiovascular risks associated with gender and aging. J Cardiovasc Dev Dis 2019;6(2):19. https://doi.org/10.3390/jcdd6020019
  14. Dalal HM, Evans PH, Campbell JL, Taylor RS, Watt A, Read KL, et al. Home-based versus hospital-based rehabilitation after myocardial infarction: a randomized trial with preference arms--Cornwall Heart Attack Rehabilitation Management Study (CHARMS). Int J Cardiol 2007;119(2):202-11. https://doi.org/10.1016/j.ijcard.2006.11.018
  15. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007;39(2):175-91. https://doi.org/10.3758/BF03193146
  16. Choi JY, Jang KS, Choi SH, Hong MS. Validity and reliability of a clinical performance examination using standardized patients. J Korean Acad Nurs 2008;38(1):83-91. https://doi.org/10.4040/jkan.2008.38.1.83
  17. Van Laethem C, De Sutter J, Peersman W, Calders P. Intratest reliability and test-retest reproducibility of the oxygen uptake efficiency slope in healthy participants. Eur J Cardiovasc Prev Rehabil 2009;16(4):493-8. https://doi.org/10.1097/HJR.0b013e32832c88a8
  18. Poole DC, Jones AM. Measurement of the maximum oxygen uptake Vo2 max: Vo2 peak is no longer acceptable. J Appl Physiol (1985) 2017;122(4):997-1002. https://doi.org/10.1152/japplphysiol.01063.2016
  19. Howley ET, Bassett DR Jr, Welch HG. Criteria for maximal oxygen uptake: review and commentary. Med Sci Sports Exerc 1995;27(9):1292-301.
  20. Posner JD, Gorman KM, Klein HS, Woldow A. Exercise capacity in the elderly. Am J Cardiol 1986;57(5):52C-58C. https://doi.org/10.1016/0002-9149(86)91027-1
  21. Gill TM, DiPietro L, Krumholz HM. Role of exercise stress testing and safety monitoring for older persons starting an exercise program. JAMA 2000;284(3):342-9. https://doi.org/10.1001/jama.284.3.342
  22. Hollenberg M, Ngo LH, Turner D, Tager IB. Treadmill exercise testing in an epidemiologic study of elderly subjects. J Gerontol A Biol Sci Med Sci 1998;53(4):B259-67. https://doi.org/10.1093/gerona/53A.4.B259
  23. Amann M, Subudhi AW, Walker J, Eisenman P, Shultz B, Foster C. An evaluation of the predictive validity and reliability of ventilatory threshold. Med Sci Sports Exerc 2004;36(10):1716-22. https://doi.org/10.1249/01.MSS.0000142305.18543.34
  24. Cheitlin MD, Armstrong WF, Aurigemma GP, Beller GA, Bierman FZ, Davis JL, et al. ACC/AHA/ASE 2003 guideline update for the clinical application of echocardiography: summary article: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (ACC/AHA/ASE Committee to update the 1997 guidelines for the clinical application of echocardiography). Circulation 2003;108(9):1146-62. https://doi.org/10.1161/01.CIR.0000073597.57414.A9
  25. Lebeau R, Di Lorenzo M, Amyot R, Veilleux M, Lemieux R, Sauve C. A new tool for estimating left ventricular ejection fraction derived from wall motion score index. Can J Cardiol 2003;19(4):397-404.
  26. Harnett JD, Murphy B, Collingwood P, Purchase L, Kent G, Parfrey PS. The reliability and validity of echocardiographic measurement of left ventricular mass index in hemodialysis patients. Nephron 1993;65(2):212-4. https://doi.org/10.1159/000187476
  27. Akkerman M, van Brussel M, Bongers BC, Hulzebos EH, Helders PJ, Takken T. Oxygen uptake efficiency slope in healthy children. Pediatr Exerc Sci 2010;22(3):431-41. https://doi.org/10.1123/pes.22.3.431
  28. Arena R, Guazzi M, Myers J, Chase P, Bensimhon D, Cahalin LP, et al. The relationship between minute ventilation and oxygen consumption in heart failure: comparing peak VE/VO2 and the oxygen uptake efficiency slope. Int J Cardiol 2012;154(3):384-5. https://doi.org/10.1016/j.ijcard.2011.11.038
  29. Wu C, Guo J, Liu H, Pudasaini B, Yang W, Zhao Q, et al. The correlation of decreased heart rate recovery and chronotropic incompetence with exercise capacity in idiopathic pulmonary arterial hypertension patients. Biomed Res Int 2017;2017:3415401. https://doi.org/10.1155/2017/3415401
  30. Ponikowski P, Francis DP, Piepoli MF, Davies LC, Chua TP, Davos CH, et al. Enhanced ventilatory response to exercise in patients with chronic heart failure and preserved exercise tolerance: marker of abnormal cardiorespiratory reflex control and predictor of poor prognosis. Circulation 2001;103(7):967-72. https://doi.org/10.1161/01.CIR.103.7.967
  31. Piepoli M, Clark AL, Volterrani M, Adamopoulos S, Sleight P, Coats AJ. Contribution of muscle afferents to the hemodynamic, autonomic, and ventilatory responses to exercise in patients with chronic heart failure: effects of physical training. Circulation 1996;93(5):940-52. https://doi.org/10.1161/01.CIR.93.5.940
  32. Scott AC, Francis DP, Davies LC, Ponikowski P, Coats AJ, Piepoli MF. Contribution of skeletal muscle 'ergoreceptors' in the human leg to respiratory control in chronic heart failure. J Physiol 2000;529(Pt 3):863-70. https://doi.org/10.1111/j.1469-7793.2000.00863.x
  33. Sullivan MJ, Cobb FR. The anaerobic threshold in chronic heart failure. Relation to blood lactate, ventilatory basis, reproducibility, and response to exercise training. Circulation 1990;81(1 Suppl):II47-58.
  34. Bocchi EA, Guimaraes GV, Moreira LF, Bacal F, de Moraes AV, Barreto AC, et al. Peak oxygen consumption and resting left ventricular ejection fraction changes after cardiomyoplasty at 6-month follow-up. Circulation 1995;92(9 Suppl):II216-22.