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CJAP ›› 2021, Vol. 37 ›› Issue (2): 208-218.doi: 10.12047/j.cjap.0098.2021.126

• ORIGINAL ARTICLES • Previous Articles     Next Articles

The new theory CPET guides the overall plan of individualized precision exercise to effectively improve the overall functional status of “frailty”

LI Hui-min1,2, SUN Xing-guo1,3△, TAI Wen-qi1, SONG Ya1,3, HAO Lu1,3, ZHANG Ye1, LIU Fang1, WANG Ji-nan1,3, ZHOU Qing-qing1,3, XU Dan-dan4, XU Fan1, SHI Chao1   

  1. 1. Department of Cardiology,Fuwai Hospital,Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037;
    2. Ganzhou People's Hospital, Ganzhou 341000;
    3. Rehabilitation Hospital Affiliated to Chongqing Medical University, Chongqing 400000;
    4. Hubei Hospital of Traditional Chinese Medicine, Wuhan 430000, China
  • Received:2020-08-12 Revised:2021-03-10 Online:2021-03-28 Published:2021-10-20

Abstract: Objective: Under the guidance of the new theory of holistic integrated physiology and medicine, the effect of individualized accurate exercise program on the overall functional state was studied according to cardiopulmonary exercise testing (CPET). Methods: Li xx, female, 31 years old, has a fast heart rate since childhood (90~100 bpm), usually feel cold, especially in autumn and winter, and general health good. CPET was performed after signing the informed consent form at Fuwai Hospital in September 2019. Peak oxygen uptake, anaerobic threshold (AT), and peak cardiac output were (69~72)% pred, respectively, and the oxygen uptake ventilation efficiency and carbon dioxide exhaust ventilation efficiency were basically normal (96~100)% pred. The resting heart rate was fast, the blood pressure was low, the blood pressure response was weak during exercise, and the heart rate was mainly increased. The holistic integrated physiology medical theory pointed out that she was in weak health and heart weakness was the main manifestation. CPET was used to guide individualized precise exercise intensity titration, combine continuous beat-by-beat blood pressure, ECG, pulse and blood glucose dynamic monitoring to formulate an holisticplan of individualized quantitative exercise .Reexamine CPET after 8 weeks' strengthening management. Results: After 8 weeks of intensive holistic management, the limbs were warm and the cold symptoms disappeared. Re-examination of CPET peak oxygen uptake, AT and peak cardiac output were (90~98)% pred, which increased by (30~36)% respectively, and the holistic weak functional status was significantly improved; basically normal oxygen uptake ventilation efficiency and carbon dioxide exhaust ventilation efficiency also increased by (10~37)% respectively; resting heart rate and blood pressure basically returned to normal, and blood pressure and heart rate response during exercise were normal. Continuous ambulatory blood glucose monitoring indicated that the average blood glucose level decreased slightly and became more stable. Repeated measurement results of continuous ECG and beat-to-beat blood pressure also indicated a decrease in heart rate and an increase in blood pressure during rest, exercise and during sleep, and radial pulse wave. The amplitude of the dicrotic wave increases and becomes more pronounced. Conclusion: The new theoretical system to guide CPET to formulate an holistic plan for individualized precision exercise can safely and effectively enhance myocardial contractility, increase stroke volume, increase blood pressure, lower heart rate, stabilize and slightly lower blood glucose, and improve holistic functional status.

Key words: individualized precision exercise overall plan, holistic integrated physiology medicine, cardiopulmonary exercise testing, pulse wave, beat-by-beat blood pressure, continuous blood glucose

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