{"title":"基于心肺运动试验的评价苏比里尔/缬沙坦对急性心肌梗死患者住院期间运动后血压反应的影响","authors":"Chun-Mei Zeng, Yan-Mei Zhao, Yi-Yi Li, Zhi-Hai Lin, Ping Li, Ying Feng, Jian-Ping Tan, Kai-Fang Pang","doi":"10.1080/10641963.2022.2055765","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effects of sacubitril/valsartan (S/V) on cardiopulmonary function and blood pressure response to exercise during hospitalization in patients with acute myocardial infarction (AMI) based on the cardiopulmonary exercise test (CPET).</p><p><strong>Methods: </strong>A total of 265 AMI patients were treated with either perindopril or S/V within 24 hours of admission. CPET was completed for all patients before discharge. There were 182 cases in the perindopril group and 83 cases in the S/V group.</p><p><strong>Results: </strong>The proportion of exercise oscillatory ventilation (EOV) was higher in the S/V group than in the perindopril group (10.8% <i>vs</i> 1.6%, <i>X<sup>2</sup> </i>= 11.148, <i>P</i> = .001). The resting heart rate (HR), resting diastolic blood pressure (DBP), and warm-up DBP were lower in the S/V group than in the perindopril group (<i>P</i> < .05). The resting systolic blood pressure (SBP) was 9.0 mmHg lower (115.7 ± 17.5 vs 106.7 ± 15.0, <i>P</i> < .001), the SBP during warm-up was 9.5 mmHg lower (124.8 ± 23.7 vs 115.3 ± 22.5,<i>P</i> = .002), the SBP at the anaerobic threshold (AT) was 10.5 mmHg lower (135.3 ± 24.8 vs 127.1 ± 25.1,<i>P</i> = .021),the SBP at max watts was 11.5 mmHg lower (148.9 ± 26.4 vs 137.4 ± 26.4,<i>P</i> = .001), and the SBP during one-minute recovery was 12.3 mmHg lower (146.5 ± 27.1 vs 134.2 ± 24.4, <i>P</i> = .001)in the S/V group than in the perindopril group. The S/V group had a higher oxygen ventilation equivalent and carbon dioxide ventilation equivalent (VE/VCO<sub>2</sub>) at AT and a lower oxygen uptake-work rate relationship during max watts (<i>P</i> < .05). The differences in the oxygen pulse, stroke volume, peak oxygen uptake (VO<sub>2 peak</sub>), and VE/VCO<sub>2</sub> slope were not statistically significant between the two groups.</p><p><strong>Conclusion: </strong>Treatment with S/V was able to reduce the exercise blood pressure in patients with AMI during hospitalization, but did not significantly improve the VO<sub>2 peak</sub>, VE/VCO<sub>2</sub> slope, or exercise tolerance.</p>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":" ","pages":"397-402"},"PeriodicalIF":16.4000,"publicationDate":"2022-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Cardiopulmonary exercise test-based assessment of the effects of sacubitril/valsartan on the blood pressure response to exercise in patients with acute myocardial infarction during hospitalization.\",\"authors\":\"Chun-Mei Zeng, Yan-Mei Zhao, Yi-Yi Li, Zhi-Hai Lin, Ping Li, Ying Feng, Jian-Ping Tan, Kai-Fang Pang\",\"doi\":\"10.1080/10641963.2022.2055765\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To investigate the effects of sacubitril/valsartan (S/V) on cardiopulmonary function and blood pressure response to exercise during hospitalization in patients with acute myocardial infarction (AMI) based on the cardiopulmonary exercise test (CPET).</p><p><strong>Methods: </strong>A total of 265 AMI patients were treated with either perindopril or S/V within 24 hours of admission. CPET was completed for all patients before discharge. There were 182 cases in the perindopril group and 83 cases in the S/V group.</p><p><strong>Results: </strong>The proportion of exercise oscillatory ventilation (EOV) was higher in the S/V group than in the perindopril group (10.8% <i>vs</i> 1.6%, <i>X<sup>2</sup> </i>= 11.148, <i>P</i> = .001). The resting heart rate (HR), resting diastolic blood pressure (DBP), and warm-up DBP were lower in the S/V group than in the perindopril group (<i>P</i> < .05). The resting systolic blood pressure (SBP) was 9.0 mmHg lower (115.7 ± 17.5 vs 106.7 ± 15.0, <i>P</i> < .001), the SBP during warm-up was 9.5 mmHg lower (124.8 ± 23.7 vs 115.3 ± 22.5,<i>P</i> = .002), the SBP at the anaerobic threshold (AT) was 10.5 mmHg lower (135.3 ± 24.8 vs 127.1 ± 25.1,<i>P</i> = .021),the SBP at max watts was 11.5 mmHg lower (148.9 ± 26.4 vs 137.4 ± 26.4,<i>P</i> = .001), and the SBP during one-minute recovery was 12.3 mmHg lower (146.5 ± 27.1 vs 134.2 ± 24.4, <i>P</i> = .001)in the S/V group than in the perindopril group. The S/V group had a higher oxygen ventilation equivalent and carbon dioxide ventilation equivalent (VE/VCO<sub>2</sub>) at AT and a lower oxygen uptake-work rate relationship during max watts (<i>P</i> < .05). The differences in the oxygen pulse, stroke volume, peak oxygen uptake (VO<sub>2 peak</sub>), and VE/VCO<sub>2</sub> slope were not statistically significant between the two groups.</p><p><strong>Conclusion: </strong>Treatment with S/V was able to reduce the exercise blood pressure in patients with AMI during hospitalization, but did not significantly improve the VO<sub>2 peak</sub>, VE/VCO<sub>2</sub> slope, or exercise tolerance.</p>\",\"PeriodicalId\":1,\"journal\":{\"name\":\"Accounts of Chemical Research\",\"volume\":\" \",\"pages\":\"397-402\"},\"PeriodicalIF\":16.4000,\"publicationDate\":\"2022-07-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Accounts of Chemical Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/10641963.2022.2055765\",\"RegionNum\":1,\"RegionCategory\":\"化学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/3/22 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"CHEMISTRY, MULTIDISCIPLINARY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Accounts of Chemical Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/10641963.2022.2055765","RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/3/22 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CHEMISTRY, MULTIDISCIPLINARY","Score":null,"Total":0}
引用次数: 0
摘要
目的:通过心肺运动试验(CPET)观察苏比利/缬沙坦(S/V)对急性心肌梗死(AMI)患者住院期间心肺功能和血压对运动反应的影响。方法:265例AMI患者在入院24小时内接受培哚普利或S/V治疗。所有患者出院前均完成CPET检查。培哚普利组182例，S/V组83例。结果:S/V组患者运动振荡通气(EOV)比例高于培哚普利组(10.8% vs 1.6%， X2 = 11.148, P = .001)。静息心率(HR)、舒张压(菲律宾),休息和热身菲律宾在S / V组低于培组(P P P = .002), SBP的无氧阈值(在)低10.5毫米汞柱(135.3±24.8 vs 127.1±25.1,P = .021), SBP在马克斯·瓦茨低11.5毫米汞柱(148.9±26.4 vs 137.4±26.4,P =措施),在一分钟和SBP的复苏是12.3毫米汞柱低(146.5±27.1 vs 134.2±24.4,P =措施)的S / V组比培组。S/V组at时氧通气量和二氧化碳通气量(VE/VCO2)较高，最大功率(P 2峰值)时氧吸收功速率关系较低，两组间VE/VCO2斜率差异无统计学意义。结论:S/V治疗能够降低AMI患者住院期间的运动血压，但不能显著改善VO2峰值、VE/VCO2斜率或运动耐量。
Cardiopulmonary exercise test-based assessment of the effects of sacubitril/valsartan on the blood pressure response to exercise in patients with acute myocardial infarction during hospitalization.
Objective: To investigate the effects of sacubitril/valsartan (S/V) on cardiopulmonary function and blood pressure response to exercise during hospitalization in patients with acute myocardial infarction (AMI) based on the cardiopulmonary exercise test (CPET).
Methods: A total of 265 AMI patients were treated with either perindopril or S/V within 24 hours of admission. CPET was completed for all patients before discharge. There were 182 cases in the perindopril group and 83 cases in the S/V group.
Results: The proportion of exercise oscillatory ventilation (EOV) was higher in the S/V group than in the perindopril group (10.8% vs 1.6%, X2= 11.148, P = .001). The resting heart rate (HR), resting diastolic blood pressure (DBP), and warm-up DBP were lower in the S/V group than in the perindopril group (P < .05). The resting systolic blood pressure (SBP) was 9.0 mmHg lower (115.7 ± 17.5 vs 106.7 ± 15.0, P < .001), the SBP during warm-up was 9.5 mmHg lower (124.8 ± 23.7 vs 115.3 ± 22.5,P = .002), the SBP at the anaerobic threshold (AT) was 10.5 mmHg lower (135.3 ± 24.8 vs 127.1 ± 25.1,P = .021),the SBP at max watts was 11.5 mmHg lower (148.9 ± 26.4 vs 137.4 ± 26.4,P = .001), and the SBP during one-minute recovery was 12.3 mmHg lower (146.5 ± 27.1 vs 134.2 ± 24.4, P = .001)in the S/V group than in the perindopril group. The S/V group had a higher oxygen ventilation equivalent and carbon dioxide ventilation equivalent (VE/VCO2) at AT and a lower oxygen uptake-work rate relationship during max watts (P < .05). The differences in the oxygen pulse, stroke volume, peak oxygen uptake (VO2 peak), and VE/VCO2 slope were not statistically significant between the two groups.
Conclusion: Treatment with S/V was able to reduce the exercise blood pressure in patients with AMI during hospitalization, but did not significantly improve the VO2 peak, VE/VCO2 slope, or exercise tolerance.
期刊介绍：
Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance.
Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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