The effects of CPET-guided cardiac rehabilitation on the cardiopulmonary function, the exercise endurance, and the NT-proBNP and hscTnT levels in CHF patients

Abstract

Objective: To explore the effects of cardiopulmonary exercise testing (CPET) on the cardiopulmonary function, the exercise endurance, and the NT-proBNP and hscTnT levels in chronic heart failure (CHF) patients.

Methods: Altogether 98 patients with CHF were randomly divided into a control group and a CPET group, with 49 cases in each group. The control group was administered routine treatment, and the CPET group was administered CPET cardiac rehabilitation training in addition to the routine treatment. Heart and lung function, exercise endurance, and the peripheral blood NTproBNP, hscTnT, and CRP levels were observed. The patients' quality of life, anxiety, and depression were observed using the scale.

Results: After the treatment, the left ventricular end systolic diameters (LVESD) and the left ventricular end diastolic diameters (LVEDD) were significantly decreased, the left ventricular ejection fractions (LVEF), the stroke volumes (SV), and the CI levels were significantly increased, and there were significant differences in these indexes between the CPET group and the control group (all P<0.05). After the treatment, the carbon dioxide ventilation equivalent slope (VE/VCO₂slop) decreased significantly, the peak oxygen consumption (peakVO₂) and anaerobic threshold oxygen consumption (VO₂AT) levels increased significantly, and there were significant differences in these indicators between the CPET group and the control group (all P<0.05). Compared with the control group, the exercise endurance, the maximum oxygen uptake capacity (VO₂max), the maximum power, the exhaustion times, and the six-minute walking test (6MWT) levels in the CPET group increased significantly (all P<0.05). After the treatment, the N-terminal precursor brain natriuretic peptide (NTproBNP), the high sensitivity cardiac troponin (hscTnT), and the C-reactive protein (CRP) levels in the two groups were decreased compared with their pre-treatment levels, and there were significant differences in these indexes between the CPET group and the control group (all P<0.05). After the treatment, the Minnesota living with heart failure questionnaire (MLHFQ), the self-rating anxiety scale (SAS), and the self-rating depression scale (SDS) scores in the two groups were significantly lower than they were before the treatment, and there were significant differences in the two scores between the CPET group and the control group (all P<0.05).

Conclusion: CPET for patients with CHF helps increase heart and lung function, improves exercise endurance, reduces the NT-proBNP and hscTnT levels, and improves patients' quality of life.

Keywords: Chronic heart failure; N-terminal precursor brain natriuretic peptide (NTproBNP); cardiopulmonary exercise testing; cardiopulmonary function; endurance test; high sensitivity cardiac troponin.

Figure 1

The serum NTproBNP, hscTnT, and CRP levels in the two groups. A. NTproBNP; B. hscTnT; C. CRP. Compared with before the treatment, ##P<0.01, ###P<0.001; compared with the control group after the treatment, ***P<0.001. NTproBNP: N-terminal precursor brain natriuretic peptide; hscTnT: high sensitive cardiac troponin; CRP: C-reactive protein; CPET: cardiopulmonary exercise test.