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Respuesta arterial sistémica al ejercicio en pacientes con estenosis de la válvula aórtica
Warren K Laskey1, William G Kussmaul, Abraham Noordergraaf
1Division of Cardiology, Department of Medicine, University of New Mexico, Albuquerque, NM 87131, USA. warrenlaskey@earthlink.net
Circulation
|February 11, 2009
Resumen
Los pacientes con estenosis de la válvula aórtica (AVS) presentan una mayor carga arterial y rigidez, lo que lleva a una respuesta de salida de ictus reducida durante el ejercicio. Este endurecimiento arterial es un factor clave en la disminución de la capacidad de ejercicio observada en el AVS.
Área de la Ciencia:
- Fisiología cardiovascular fisiología cardiovascular.
- Ingeniería Biomédica Ingeniería Biomédica.
- La hemodinámica clínica es la hemodinámica.
Sus antecedentes:
- La hemodinámica arterial sistémica es crucial para evaluar la gravedad y las consecuencias de la estenosis de la válvula aórtica (AVS).
- Comprender la carga arterial en AVS es esencial para el manejo de los resultados de los pacientes.
Objetivo del estudio:
- Investigar las propiedades hemodinámicas arteriales sistémicas en pacientes con AVS en reposo y durante el ejercicio.
- Para determinar la contribución de la carga arterial a la disminución de la respuesta al ejercicio en el AVS.
Principales métodos:
- Se obtuvieron grabaciones de catéter de alta fidelidad de la presión aórtica ascendente y la velocidad de flujo sanguíneo.
- Las mediciones se tomaron en reposo y durante el ejercicio de bicicleta supina en 18 pacientes con AVS y 11 controles.
- Se calculó la resistencia vascular sistémica, el cumplimiento arterial, la elasticidad arterial y la impedancia característica aórtica.
Principales resultados:
- Los pacientes con EVA mostraron un aumento de la resistencia vascular sistémica, la elasticidad arterial y la impedancia característica aórtica en reposo en comparación con los controles.
- El cumplimiento arterial total fue menor en pacientes con EVA en reposo y no aumentó con el ejercicio, a diferencia de los controles.
- El ejercicio condujo a un aumento de la elasticidad arterial en pacientes con EVA, mientras que el incremento del flujo del accidente cerebrovascular se atenuó.
Conclusiones:
- Los pacientes con EVA tienen elevados componentes de carga arterial estables y pulsátiles, independientemente de la presión.
- El endurecimiento arterial persistente en AVS contribuye significativamente al deterioro de la respuesta de salida del accidente cerebrovascular al ejercicio.
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