UNASSIGNED: The aim of this study was to explore the effects of different exercise stimulation modes on the occurrence of safety events during CPET in patients with CHD.
UNASSIGNED: A total of 10,538 CPETs, including 5,674 performed using treadmill exercise and 4,864 performed using bicycle ergometer exercise at Peking University Third Hospital, were analyzed retrospectively. The incidences of CV events and serious adverse events during CPET were compared between the two exercise groups.
UNASSIGNED: Cardiovascular events in enrolled patients occurred during 355 CPETs (3.4%), including 2 cases of adverse events (0.019%), both in the treadmill group. The incidences of overall events [235 (4.1%) vs. 120 (2.5%), P < 0.001], premature ventricular contractions (PVCs) [121 (2.1%) vs. 63 (1.3%), P = 0.001], angina pectoris [45 (0.8%) vs. 5 (0.1%), P < 0.001], and ventricular tachycardia (VT) [32 (0.6%) vs. 14 (0.3%), P = 0.032] were significantly higher in the treadmill group compared with the bicycle ergometer group. No significant difference was observed in the incidence of bradyarrhythmia and atrial arrhythmia between the two groups. Logistic regression analysis showed that the occurrence of overall CV events (P < 0.001), PVCs (P = 0.007), angina pectoris (P < 0.001), and VT (P = 0.008) was independently associated with the stimulation method of treadmill exercise. In male subjects, the occurrence of overall CV events, PVCs, angina pectoris, and VT were independently associated with treadmill exercise, while only the overall CV events and angina pectoris were independently associated with treadmill exercise in female subjects.
UNASSIGNED: In comparison with treadmill exercise, bicycle ergometer exercise appears to be a safer exercise stimulation mode for CPET in patients with CHD.
■本研究的目的是探讨不同运动刺激模式对冠心病患者CPET期间安全事件发生的影响。
■总共10,538个CPET,包括在北京大学第三医院使用跑步机锻炼进行的5,674人和使用自行车测功机锻炼进行的4,864人,进行了回顾性分析。比较两个运动组CPET期间CV事件和严重不良事件的发生率。
■在355个CPET(3.4%)期间发生了心血管事件,包括2例不良事件(0.019%),都在跑步机组。总体事件的发生率[235(4.1%)与120(2.5%),P<0.001],室性早搏(PVC)[121(2.1%)与63(1.3%),P=0.001],心绞痛[45(0.8%)与5(0.1%),P<0.001],室性心动过速(VT)[32(0.6%)与14(0.3%),P=0.032]在跑步机组明显高于自行车测功机组。两组缓慢性心律失常和房性心律失常的发生率差异无统计学意义。Logistic回归分析显示,总体CV事件发生率(P<0.001),PVC(P=0.007),心绞痛(P<0.001),和VT(P=0.008)与跑步机运动的刺激方法独立相关。在男性受试者中,总体CV事件的发生,PVC,心绞痛,室性心动过速与跑步机运动独立相关,而在女性受试者中,只有整体CV事件和心绞痛与跑步机运动独立相关。
■与跑步机运动相比,自行车测功机运动似乎是CHD患者CPET更安全的运动刺激模式。