한국성인의 대사증후군 예방을 위한 운동부하 검사시 각 단계별 심근부담률의 적정 임계점
Optimal Cutoff Points of Rate Pressure Product in Each Stage of Treadmill Exercise Test According to the Degree of Metabolic Syndrome in Korean Adults
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초록
심근부담률은 심근산소소비량을 간접적으로 측정하는 지표로 심박수와 수축기 혈압의 곱으로 나타내며, 심근이 받는 부담을 나타낸다. 본 연구는 한국성인을 대상으로 트레드밀 운동부하 검사시 대사증후군에 따른 심근부담률의 적정 수준을 제시함으로써 대사증후군 유병률을 낮추기 위한 심근부담률의 목표치를 설정하여 그 기준을 제시하고자 하였다. 대사증후군 진단은 National Cholesterol Education Program (NCEP)의Adult Treatment Panel (ATP) III에서 제시한 5가지 진단기준중 3개 이상 충족하는 경우 대사증후군 진단군(MetS, N=25), 1∼2개의 기준에 해당하는 경우를 대사증후군 전단계군(Pre-MetS, N=106), 5개의 진단기준에 해당하지 않는 경우는대사증후군 위험요인이 없는군(Non-MetS, N=65)으로 분류하였다. 운동부하검사는 Bruce 프로토콜에 따라 시행하였다. 심근부담률은(심박수×수축기 혈압)÷1,000으로 구하였다. 본연구결과 대사증후군 진단군에서 도달한 일량이 낮음에도 불구하고 최대 수축기 혈압이 높은 것으로 나타났다. 또한 대사증후군에 따른 운동부하 검사시 심근부담률의 최적 임계점은 운동부하검사 1단계에서는 12.56 mmHg×beats/min×10-3, 운동부하검사 2단계는 16.94 mmHg×beats/min×10-3, 운동부하검사 3단계에서는 21.11 mmHg×beats/min×10-3로 나타났다.
Abstract
The rate pressure product (RPP) is expressed as a product of the heart rate and systolic blood pressure as an index indirectly measuring the myocardial oxygen consumption, and it indicates the burden on the myocardium. The aim of this study was to determine the optimal level of RPP for preventing metabolic syndrome in a treadmill exercise test in Korean adults. Metabolic syndrome was the diagnosis of the third executive summary report on the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria. According to the criteria, the metabolic syndrome diagnosis group (MetS, N=25), pre-metabolic syndrome group (Pre-MetS, N=106), and non-risk factor group (Non-MetS, N=65) were classified. The exercise stress test was performed based on the Bruce protocol. The RPP was calculated as (heart rate×systolic blood pressure)÷ 1,000. The results showed that the maximum systolic blood pressure was high despite the low daily dose reached in the diagnostic group of metabolic syndrome. The optimal threshold of the RPP at the time of the exercise treadmill test for a metabolic syndrome prediction was 12.56 mmHg×beats/min×10-3 in the first stage of the exercise stress test. The second stage of the exercise test was 16.94 mmHg×beats/min×10-3, and at the third stage of the exercise test was 21.11 mmHg×beats/min×10-3.
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