关键词: 血压, 心率, 症状限制性极限运动, 心肺运动试验, 终止运动标准, 安全与风险

Abstract: Objective　To analyze the data concerning systolic blood pressure（SBP） and heart rate（HR） in symptom-limited maximal cardiopulmonary exercise tests（CPETs），in order to explore whether it is right or not to use 85% of maximal age-predicted heart rate（85% MPHR） and a specific SBP level to terminate the CPET.Methods　Data of 112 symptom-limited maximal CPETs completed with incremental protocols by 85 participants in the cardiopulmonary exercise laboratory of Ronald Reagan UCLA Medical Center，between January 1974 and January 2004 were collected from the Principles of Exercise Testing and Interpretation （Fourth Edition）．We analyzed 111 CPETs with HR data（the other one was excluded due to lack of corresponding data） and 97 CPETs with intra-arterial blood pressure（the other 15 were excluded due to lack of corresponding data）．We calculated and counted the number and percentage of the CPETs with recorded maximum HR ≥85% MPHR，and compared the differences and percentage differences of exercise duration（time），work rate（WR），HR，breath frequency（f），minute ventilation（V?E），carbon dioxide output（V?CO2），oxygen uptake（V?O2），oxygen pulse （O2P），and respiratory exchange ratio（RER） at peak exercise and while HR reached 85%MPHR using paired t test.We also did the similar calculation and count of the number and percentage of the CPETs with recorded SBP≥210，220 and 250 mmHg，and the comparisons of the differences and percentage differences of the aforementioned parameters between the peak exercise and while SBP≥210，220 and 250 mm Hg.Results　There were 64（58%） CPETs during which the maximum HR ≥85% MPHR，in all of 111 CPETs with recorded HR.There were significant differences for all measurements of time，WR，HR，f，V?E，V?CO2，V?O2，O2P and RER（P<0.001） between the peak and HR≥85% MPHR in these 64 CPETs.There were 39，28 and 9 CPETs during which the peak SBP≥210，220 and 250 mm Hg，respectively，in all of 97 CPETs with recorded intra-arterial BP.There were significant differences for all measurements of 9 parameters（time，WR，HR，f，V?E，V?CO2，V?O2，O2P，and RER）（P<0.05） between the peak exercise and while SBP≥210 and 220 mm Hg in these 39 and 28 CPETs，respectively.However，there were no significant differences for all measurements of the above-mentioned 9 parameters between the peak exercise and SBP≥250 mm Hg（P>0.05） in these 9 CPETs.Conclusion　As not all of （only most of） the participants had a maximum HR ≥85% MPHR，and a minority of them had a SBP ≥210 mm Hg during the CPET，we should not affirm that the participants fail to achieve a maximal effort during CPET even if the maximum HR <85% MPHR and/or peak SBP <210 mm Hg.Moreover，we should not stop the exercise by maximum HR≥85% MPHR and /or peak SBP≥210 or 220 mm Hg.However，we may consider to use the SBP≥ 250 mm Hg as an indicator of termination of CPET.

Key words: Blood pressure, Heart rate, Symptom limited peak exercise, Cardiopulmonary exercise testing, Standard for stopping exercise, Safety and risk