冠心病人群运动靶心率无氧阈法与心率储备法一致性评价

韩凌; 刘强; 刘业发; 范晓绵; 徐笛; 侯永洪; 王东伟; 丁荣晶

doi:10.16766/j.cnki.issn.1674-4152.003237

冠心病人群运动靶心率无氧阈法与心率储备法一致性评价

doi: 10.16766/j.cnki.issn.1674-4152.003237

韩凌^{1, 2},
刘强³,
刘业发²,
范晓绵²,
徐笛⁴,
侯永洪⁴,
王东伟¹,
丁荣晶^{2, 5, ,}

1.
郑州大学附属郑州中心医院心脏康复科，河南郑州 450000
2.
北京大学人民医院心血管内科，北京 100044
3.
首都医科大学附属北京胸科医院，北京 101125
4.
天津体育学院，天津 301617
5.
中国医学科学院北京协和医院物理医学康复科，北京 100730

基金项目:

河南省医学科技攻关计划联合共建项目 2018020774

详细信息

通讯作者:
丁荣晶，E-mail：drj2003@vip.163.com

中图分类号: R541.4 R540.4
计量
- 文章访问数: 277
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- PDF下载量: 13
- 被引次数: 0
出版历程
- 收稿日期: 2023-03-12
- 网络出版日期: 2024-01-13

Evaluation of the agreement between the anaerobic threshold and heart rate reserve methods of target exercise heart rate in a population with coronary artery disease

HAN Ling^{1, 2},
LIU Qiang³,
LIU Yefa²,
FAN Xiaomian²,
XU Di⁴,
HOU Yonghong⁴,
WANG Dongwei¹,
DING Rongjing^{2, 5
, ,}

1.
Department of Cardiac Rehabilitation Medicine, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan 450000, China

摘要

摘要: 目的通过心肺运动试验(CPET)所得无氧阈靶心率与心率储备法所得靶心率进行比较，检验不同方法所得靶心率的一致性，以指导制定运动处方。方法纳入2013年1月—2020年1月郑州市中心医院和北京大学人民医院确诊冠心病患者324例，采集CPET检查测得的无氧阈对应心率、静息心率以及实测最大心率等数据。通过组内相关系数(ICC)和Bland Altman法，比较CPET测定的无氧阈靶心率法和心率储备法计算的运动靶心率的一致性。结果 324例患者无氧阈靶心率为(101.1±15.8)次/min，50%、60%、70%强度心率储备法靶心率分别为(102.2±13.5)次/min、(109.1±14.2)次/min、(113.6±15.1)次/min，无氧阈靶心率与50%强度心率储备法靶心率比较，差异无统计学意义(P=0.183)。无氧阈靶心率与50%强度心率储备法靶心率一致性检验的ICC值为0.781，95% CI：0.727~0.824，P<0.001；Bland Altman评价结果显示无氧阈靶心率与50%强度心率储备法靶心率的比值为0.99±0.12，95%一致性界限(LOA)为0.755~1.220。根据性别、年龄(≥65岁和<65岁)、是否曾发生心肌梗死、是否应用β受体阻滞剂以及是否完全血运重建进行亚组分析，ICC值范围在0.737~0.811(均P<0.001)，结果显示各组一致性均好。结论在冠心病人群中，50%强度心率储备法靶心率与无氧阈靶心率一致性较好，临床中在无法接触心肺运动试验时可作为替代方案。
- 冠心病 /
- 靶心率 /
- 无氧阈心率 /
- 心率储备法 /
- 运动处方
Abstract: Objective To compare the anaerobic threshold target heart rate obtained from cardiopulmonary exercise test (CPET) with the target heart rate obtained from the heart rate reserve method to test the consistency of target heart rates obtained from different methods and to guide the formulation of exercise prescriptions. Methods A total of 324 patients with coronary heart disease diagnosed in Zhengzhou Central Hospital and Peking University People' s Hospital from January 2013 to January 2020 were included. Data of anaerobic threshold corresponding heart rate, resting heart rate and measured maximum heart rate as measured by CPET were collected. The intraclass correlation coefficient (ICC) and the Bland-Altman method was used to compare the agreement between exercise target heart rate obtained by the anaerobic threshold method and that calculated by heart rate reserve method. Results The target exercise heart rate by the anaerobic threshold method of 324 patients was (101.1±15.8) beats/min, and the target exercise heart rates at 50%, 60%, 70% intensity by heart rate reserve method were (102.2±13.5) beats/min, (109.1±14.2) beats/min, (113.6±15.1) beats/min, respectively. There was no significant difference between exercise heart rate using the anaerobic threshold method and 50% intensity heart rate reserve method (P=0.183). The ICC value of consistency test of exercise THR by anaerobic threshold method and 50% intensity heart rate reserve was 0.781, 95% CI: 0.727-0.824, P<0.001; the evaluation results of the Bland Altman method showed that ratio of the above two was 0.99±0.12, and 95% limits of agreement (LOA) was 0.755-1.220. According to gender, age (≥ 65 years and<65 years), whether myocardial infarction occurred (myocardial infarction group and angina pectoris group), whether β-blockers were applied, and whether complete revascularization was performed, further subgroup analysis showed that ICC values ranged (0.737-0.811, all P<0.001), and results showed consistency of each group was good. Conclusion In patients with coronary artery disease, the 50% intensity heart rate reserve method has good agreement with that anaerobic threshold method, which can be used as an alternative approach when cardiopulmonary exercise testing is not available in clinical practice.
- Coronary heart disease /
- Target heart rate /
- Anaerobic threshold heart rate /
- Heart rate reserve method /
- Exercise prescription

HTML全文

图 1 冠心病患者无氧阈靶心率与50%HRR靶心率一致性评价结果(Bland-Altman法)

Figure 1. Consistency evaluation results of anaerobic threshold target heart rate and 50%HRR target heart rate in patients with coronary heart disease (Bland-Altman method)

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