본문 바로가기
KERD
논문KCI 등재

Characteristics and Safety of Cardiopulmonary Exercise Testing in Elderly Patients with Cardiovascular Diseases in Korea

1

조회

0

다운로드

3

인용

0

참고문헌

키워드

주제분류의학일반

초록

Purpose: Clinical use of cardiopulmonary exercise tests (CPETs) is increasing in elderly patients with cardiovascular (CV) diseases. However, data on Korean populations are limited. In this study, we aimed to examine the characteristics and safety of CPET inan elderly Korean population with CV disease. Materials and Methods: We retrospectively analyzed records of 1485 patients (older than 65 years in age, with various underlyingCV diseases) who underwent CPET. All CPET was performed using the modified Bruce ramp protocol. Results: The mean age of patients was 71.6±4.7 years with 63.9% being men, 567 patients aged 60–65 years, 818 patients aged 70–79 years, and 100 patients aged 80–89 years. The mean respiratory exchange ratio was 1.09±0.14. During CPET, three adverse cardiovascularevents occurred (total 0.20%), all ventricular tachycardia. All subjects showed an average exercise capacity of 21.3±5.5mL/kg/min at peak VO2 and 6.1±1.6 metabolic equivalents of task, and men showed better exercise capacity than women onmost CEPT parameters. A significant difference was seen in peak oxygen uptake according to age group (65–69 years, 22.9±5.8;70–79 years, 20.7±5.1; 80–89 years, 17.0±4.5 mL/kg/min, p<0.001). The most common causes for CPET termination were dyspnea(64.8%) and leg pain (24.3%), with higher incidence of leg pain in octogenarians compared to other age groups (65–69 years,22.4%; 70–79 years, 24.6%; 80–89 years, 32.0%, p<0.001). Conclusion: CPET was relatively a safe and useful modality to assess exercise capacity, even in an elderly Korean population withunderlying CV diseases.

Abstract

Purpose: Clinical use of cardiopulmonary exercise tests (CPETs) is increasing in elderly patients with cardiovascular (CV) diseases. However, data on Korean populations are limited. In this study, we aimed to examine the characteristics and safety of CPET inan elderly Korean population with CV disease. Materials and Methods: We retrospectively analyzed records of 1485 patients (older than 65 years in age, with various underlyingCV diseases) who underwent CPET. All CPET was performed using the modified Bruce ramp protocol. Results: The mean age of patients was 71.6±4.7 years with 63.9% being men, 567 patients aged 60–65 years, 818 patients aged 70–79 years, and 100 patients aged 80–89 years. The mean respiratory exchange ratio was 1.09±0.14. During CPET, three adverse cardiovascularevents occurred (total 0.20%), all ventricular tachycardia. All subjects showed an average exercise capacity of 21.3±5.5mL/kg/min at peak VO2 and 6.1±1.6 metabolic equivalents of task, and men showed better exercise capacity than women onmost CEPT parameters. A significant difference was seen in peak oxygen uptake according to age group (65–69 years, 22.9±5.8;70–79 years, 20.7±5.1; 80–89 years, 17.0±4.5 mL/kg/min, p<0.001). The most common causes for CPET termination were dyspnea(64.8%) and leg pain (24.3%), with higher incidence of leg pain in octogenarians compared to other age groups (65–69 years,22.4%; 70–79 years, 24.6%; 80–89 years, 32.0%, p<0.001). Conclusion: CPET was relatively a safe and useful modality to assess exercise capacity, even in an elderly Korean population withunderlying CV diseases.

참고문헌 (24)

  1. Roger VL, "Heart disease and stroke statistics--2011 update : a report from the American Heart Association", Circulation, 123, pp.e18~209 (2011)
  2. Jackson CF, "Cardiovascular disease in the elderly", Rev Esp Cardiol, 64, pp.697~712 (2011)
  3. American Thoracic Society, "American College of Chest Physicians. ATS", ACCP Statement on cardiopulmonary exercise testing, 2003, pp.167, 211~277
  4. Malhotra R, "Cardiopulmonary exercise testing in heart failure", JACC Heart Fail, 4, pp.607~616 (2016)
  5. Moran J, "The preoperative use of field tests of exercise tolerance to predict postoperative outcome in intra-abdominal surgery : a systematic review", J Clin Anesth, 35, pp.446~455 (2016)
  6. Gibbons RJ, "ACC", AHA 2002 guideline update for exercise testing: summary article. A report of the American College of Cardiology, J Am Coll Cardiol, pp.2002, 40[DOI]
  7. Keteyian SJ, "Safety of symptom-limited cardiopulmonary exercise testing in patients with chronic heart failure due to severe left ventricular systolic dysfunction", Am Heart J, 158(4 Suppl), pp.S72~77 (2009)
  8. Skalski J, "The safety of cardiopulmonary exercise testing in a population with high-risk cardiovascular diseases", Circulation, 126, pp.2465~2472 (2012)
  9. Ponikowski P, "2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC", Eur J Heart Fail, 18, pp.891~975 (2016)
  10. Nishimura RA, "2014 AHA", ACC Guideline for the Management of Patients with Valvular Heart Disease : executive summary : a report of the American College of Cardiology, Circulation, pp.2014, 129[DOI]
  11. Shapiro LM, "Distribution of left ventricular hypertrophy in hypertrophic cardiomyopathy : a two-dimensional echocardiographic study", J Am Coll Cardiol, 2, pp.437~444 (1983)
  12. Gersh BJ, "2011 ACCF", AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy : executive summary : a report of the American College of Cardiology Foundation, Circulation, pp.2011, 124[DOI]
  13. Fletcher GF, "Exercise standards for testing and training : a scientific statement from the American Heart Association", Circulation, 128, pp.873~934 (2013)
  14. Scardovi AB, "The cardiopulmonary exercise test is safe and reliable in elderly patients with chronic heart failure", J Cardiovasc Med(Hagerstown), 8, pp.608~612 (2007)
  15. Myers J, "Comparison of the ramp versus standard exercise protocols", J Am Coll Cardiol, 17, pp.1334~1342 (1991)
  16. Leon MB, "Transcatheter or surgical aortic-valve replacement in intermediate-risk patients", N Engl J Med, 374, pp.1609~1620 (2016)
  17. Coats CJ, "Cardiopulmonary exercise testing and prognosis in hypertrophic cardiomyopathy", Circ Heart Fail, 8, pp.1022~1031 (2015)
  18. Sorensen LL, "Safety profile and utility of treadmill exercise in patients with high-gradient hypertrophic cardiomyopathy", Am Heart J, 184, pp.47~54 (2017)
  19. Balady GJ, "Changes in exercise capacity following cardiac rehabilitation in patients stratified according to age and gender. Results of the Massachusetts Association of Cardiovascular and Pulmonary Rehabilitation Multicenter Database", J Cardiopulm Rehabil, 16, pp.38~46 (1996)
  20. Morris CK, "Nomogram based on metabolic equivalents and age for assessing aerobic exercise capacity in men", J Am Coll Cardiol, 22, pp.175~182 (1993)
  21. Chul Kim, "Influence of Low Peak Respiratory Exchange Ratio on Cardiac Rehabilitation in Patients With Coronary Artery Disease", Annals of Rehabilitation Medicine, 40(6), pp.1114~1123 (2016), 대한재활의학회
  22. Boo SH, "Association between skeletal muscle mass and cardiorespiratory fitness in community-dwelling elderly men", Aging Clin Exp Res, 31, pp.49~57 (2019)
  23. Skelton DA, "Explosive power and asymmetry in leg muscle function in frequent fallers and non-fallers aged over 65", Age Ageing, 31, pp.119~125 (2002)
  24. Quinn TJ, "Physiologic responses of cardiac patients to supine, recumbent, and upright cycle ergometry", Arch Phys Med Rehabil, 76, pp.257~261 (1995)

관련 논문AI추천

Changes in Aerobic Capacity Over Time in Elderly Patients With Acute Myocardial Infarction During Cardiac RehabilitationHyeng-Kyu Park, In-Sung Choi, Jae-Young Han, Ki-Hong Kim, Min-Keun Song, Yun-Chol Jang대한재활의학회 · Annals of Rehabilitation Medicine2020 · 제44권 제1호Is Age-Predicted Maximal Heart Rate Applicable in Patients With Heart or Lung Disease?Byeong Ju Lee, Dong Min Kim, Ho Eun Park, Ji Won Hong, Min Soo Choi, Sang Hun Han, Sang Hun Kim, Yong Beom Shin, Young Mo Kim대한재활의학회 · Annals of Rehabilitation Medicine2022 · 제46권 제3호Influence of Low Peak Respiratory Exchange Ratio on Cardiac Rehabilitation in Patients With Coronary Artery DiseaseChul Kim, Hee Eun Choi, Ki Hoon Lee, Sang Jae Lee, Young Joo Kim대한재활의학회 · Annals of Rehabilitation Medicine2016 · 제40권 제6호Development and validation of equation for cardiorespiratory fitness in patients with heart failure with preserved ejection fractionByambakhand Battumur, Chang Gyu Park, Cheol Ung Choi, Dong Oh Kang, Eung Ju Kim, Eun Jin Park, Jah Yeon Choi, Ji Bak Kim, Ji Eun Lee, Jin Oh Na, Jin Won Kim, Seung Woon Rha, Seung Young Roh, Soo Hyung Park, You-Jung Choi대한내과학회 · The Korean Journal of Internal Medicine2023 · 제38권 제4호Safety of Monitoring Exercise for Early Hospitalbased Cardiac Rehabilitation김철, Chang Jin Moon, Min Ho Lim대한재활의학회 · Annals of Rehabilitation Medicine2012 · 제36권 제2호노인의 6분걷기 검사 타당도 검증 및 최대산소섭취량 추정식 개발이온, 류승호, 박소영한국운동생리학회 · 운동과학2023 · 제32권 제3호

이 간행물의 다른 논문 (8건)