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La ganancia de barorreflejo predice la recuperación de la presión arterial durante la taquicardia ventricular
M H Hamdan1, J A Joglar, R L Page
1University of Texas, Southwestern Medical Center, Dallas, Texas, USA. hamdan@ryburn.swmed.edu
Circulation
|July 27, 1999
Resumen
Una mayor ganancia de barorreflejo arterial mejora la recuperación de la presión arterial durante la taquicardia ventricular (TV) simulada. Este hallazgo sugiere que la ganancia de barorreflejo es clave para la estabilidad hemodinámica en pacientes con VT.
Área de la Ciencia:
- Fisiología cardiovascular fisiología cardiovascular.
- Regulación del sistema nervioso autónomo.
- Electrofisiología Clínica Electrofisiología Clínica.
Sus antecedentes:
- Las respuestas de los pacientes a la taquicardia ventricular (VT) varían a pesar de la disfunción cardíaca similar.
- La actividad del nervio simpático (SNA) aumenta durante la TR, lo que influye en los resultados hemodinámicos.
- La ganancia de barorreflejo arterial puede determinar el efecto simpatoexcitador neto en VT.
Objetivo del estudio:
- Investigar la relación entre la ganancia simpática del barorreflejo arterial y la recuperación de la presión arterial (BP) durante el ritmo ventricular rápido (VP).
- Para determinar si la ganancia de barorreflejo es un factor significativo en el mantenimiento de la estabilidad hemodinámica durante la VT simulada.
Principales métodos:
- Se midieron el ANS, la presión arterial y la CVP muscular eferente en 14 pacientes sometidos a un estudio electrofisiológico.
- Se evaluó la ganancia de barorreflejo arterial a través de la pendiente del cambio de ANS al cambio de presión arterial diastólica durante la infusión de nitroprussida.
- Recuperación de la presión arterial cuantificada durante la VP midiendo el aumento de la presión arterial media (MAP) desde el nadir hasta el estado de equilibrio.
Principales resultados:
- La ganancia de barorreflejo arterial se correlacionó positivamente con la recuperación de la MAP durante el VP (r=0.57, P=0.034).
- No se encontró una correlación significativa entre la fracción de eyección y la ganancia de barorreflejo o la recuperación de la presión arterial.
- Los pacientes con alta ganancia de barorreflejo demostraron una recuperación MAP significativamente mayor durante la TR simulada en comparación con aquellos con baja ganancia.
Conclusiones:
- La ganancia de barorreflejo arterial contribuye significativamente a la estabilidad hemodinámica durante la VT simulada.
- El barorreflex de cada paciente puede guiar terapias personalizadas para la trombosis venosa sostenida.
Palabras clave:
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