中国心血管疾病患者峰值摄氧量非运动性预测

Non-exercise prediction of peak oxygen uptake in Chinese patients with cardiovascular disease

摘要:

目的]旨在开发适用于中国心血管疾病(CVD)患者的峰值摄氧量(VO₂ peak)预测方程。 [方法]本研究是一项回顾性多中心研究,纳入2018年1月至2024年12月期间来自20家医院21 402例接受心肺运动试验(CPET)的CVD患者,根据7∶3的比例随机分为开发组(n＝14 981)和验证组(n＝6 421)。采用多元向前逐步回归分析法建立适用于中国CVD患者的VO₂ peak预测方程,并与其他队列已建立的预测方程进行比较。[结果]本研究将年龄、性别、身高、体重和CVD诊断纳入预测方程的关键影响因素建立的预测方程为:VO₂ peak (mL/min)＝246.206－[9.858×年龄(岁)]＋[187.643×性别(男＝1,女＝0)]＋[4.500×身高(cm)]＋[10.250×体重(kg)]＋[94.969×稳定型心绞痛(是＝1,否＝0)]－[39.293×经皮冠状动脉介入治疗(是＝1,否＝0)]－[110.124×心肌梗死(是＝1,否＝0)]－[208.447×心力衰竭(是＝1,否＝0)]。调整后R²＝0.51,SE＝264.0 mL/min。验证组分析显示,Wasserman预测方程(152%)、Friend健康人群预测方程(197%)、Friend CVD预测方程(117%)、中国健康人群PUTH预测方程(292%)及中国健康人群X-ET预测方程(109%)均高估了中国CVD患者的VO₂ peak,而本研究开发的中国CVD预测方程(104%)的预测结果与实测值更为接近。 [结论]本研究开发了适用于中国CVD患者的VO₂ peak预测方程,相较于现有方程,该方程预测误差更小,更适用于中国人群。

Abstract:

Aim To develop a peak oxygen uptake (VO₂ peak) prediction equation applicable to Chinese cardiovascular disease (CVD) patients. Methods This study was a retrospective multicenter study that included 21 402 CVD patients who underwent cardiopulmonary exercise testing (CPET) from 20 hospitals between January 2018 and December 2024, and randomly divided into a development group (n＝14 981) and a verification group (n＝6 421) at a ratio of 7∶3. Multiple forward stepwise regression analysis method was used to establish a VO₂ peak prediction equation suitable for Chinese CVD patients, which was compared with prediction equations established from other cohorts. Results This study incorporated age, sex, height, body weight and CVD diagnosis as key influencing factors into the predictive equation, resulting in the final predictive model:VO₂ peak (mL/min)＝246.206－ (9.858×age (years)＋(187.643×sex (male＝1, female＝0)＋(4.500×height (cm)＋(10.250×weight (kg)＋(94.969×SA (yes＝1, no＝0)－(39.293×PCI (yes＝1, no＝0)－(110.124× MI (yes＝1, no＝0)－(208.447×HF (yes＝1, no＝0). Adjusted R²＝0.51, SE＝264.0 mL/min. The validation group analysis showed that the Wasserman prediction equation (152%), Friend healthy population prediction equation (197%), Friend CVD prediction equation (117%), Chinese healthy population PUTH prediction equation (292%), and Chinese healthy population X-ET prediction equation (109%) all overestimated the VO₂ peak of Chinese CVD patients, while the prediction results of the Chinese CVD prediction equation (104%) developed in this study were closer to the measured values. Conclusion This study developed a VO₂ peak prediction equation suitable for Chinese CVD patients, which has smaller prediction errors compared to existing equations and is more suitable for the Chinese population.