孤立性心房細動患者における運動時循環呼吸系反応とａｎａｅｒｏｂｉｃ　ｔｈｒｅｓｈｏｌｄに関する検討

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  • Evaluation of circuratory and respiratory responses and gas exchange anerobic threshold during exercise in patients with lone atrial fibrillation.
  • コリツセイ シンボウ サイドウ カンジャ ニ オケル ウンドウジ ジュンカン

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Factors of circulatory and respiratory responses to the multistage maximal exercise test (a symptom-limited Bruce protocol) useing respiratory gas exchange techniques were investigated in 16 patients with lone atrial fibrillation (Af) were compared with age-matched eight normal sedentary subject (group N). The group with lone Af was classified into patients whose pretreatment rest ventricular rate was group T (≥100 beats/min, 8 patients) and those whose rate was group S (<100 beats/min, 8 patients). Responses to exercise were evaluated at the point of gas anerobic threshold (AT) and the peak exercise, Group T denoted significant increase in the heart rate and % peak heart rate as compared with group N (p<0.001) and had excessive heart rate response during AT exercises. It was suggested that the higher heart rate response was compensation for the loss of atrial function. Oxygen uptake (VO2) expressed as AT was the lowest in the group T and lower in the group S than the group N. The O2-pulse was singnificantly lower in the group T than the other groups during AT exercise (p<0.001). Moreover the group T was assessed under condition of recieving digoxin (0.25mg/day, D) alone and during combied therapy with D and verapamil (120mg/day, V) to evaluate the drug efficacy. The heart rate and O2-pulse during AT exercise improved to the level of group S by D and more improved to the level of group N by D and V. These changes of circulatory and respiratory responses were greater during AT exercise than peak exercise. In the lone Af group, heart rate closely correlated with VO2 (r=0.75) and VO2-AT correlated with peak VO2 (r=61). Thus, the results of this study suggested that AT was an useful objective index for evaluation of the exercise tolerance and judgement of the therapeutic efficacy in patients with lone Af.

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