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El flujo sanguíneo muscular durante el ejercicio del antebrazo en pacientes con insuficiencia cardíaca grave
J M Arnold1, J P Ribeiro, W S Colucci
1University of Western Ontario, London, Canada.
Circulation
|August 1, 1990
Resumen
La fatiga muscular en la insuficiencia cardíaca crónica (ICC) no se debe al deterioro del flujo sanguíneo en los músculos que hacen ejercicio. El flujo sanguíneo del antebrazo durante el ejercicio fue similar entre los pacientes con ECC y los individuos sanos, lo que sugiere una función vascular normal.
Área de la Ciencia:
- Fisiología cardiovascular fisiología cardiovascular.
- Fisiología del ejercicio Fisiología del ejercicio
Sus antecedentes:
- La fatiga muscular es un síntoma común en pacientes con insuficiencia cardíaca crónica (ICC).
- La causa subyacente puede implicar anormalidades en la capacidad vasodilatadora de ejercitar la vasculatura muscular.
Objetivo del estudio:
- Investigar si la fatiga muscular en la insuficiencia cardíaca congestiva es el resultado de una alteración de la regulación local del flujo sanguíneo durante el ejercicio.
- Para comparar el flujo sanguíneo del antebrazo (FBF) durante el ejercicio en pacientes con EHC severa versus controles sanos.
Principales métodos:
- Se estudió la FBF con plethysmografía venosa con estirómetro de mercurio en caucho durante el ejercicio estático intermitente del antebrazo al 15%, 30% y 45% de la contracción voluntaria máxima.
- Las mediciones se tomaron en reposo y durante el ejercicio en 13 pacientes con ECC y 8 sujetos sanos.
- Los pacientes con CHF fueron reevaluados después de 24 horas de administración intravenosa de milrinona.
Principales resultados:
- La FBF en reposo fue significativamente menor en pacientes con CHF en comparación con los controles (p < 0,05).
- Durante el ejercicio, la FBF no difería significativamente entre los pacientes con CHF y los controles a cualquier intensidad.
- El ejercicio pico FBF se correlacionó negativamente con la presión venosa central (r = -0.65) y positivamente con la fracción de eyección ventricular derecha (r = 0.59).
Conclusiones:
- La capacidad vasodilatadora de ejercitar la vasculatura del músculo del antebrazo parece normal en pacientes con insuficiencia cardíaca coronaria grave.
- La fatiga muscular en la insuficiencia cardíaca congestiva es poco probable que se derive de una anomalía intrínseca en la respuesta vascular local al ejercicio.
- Los factores hemodinámicos como la presión venosa central y la función ventricular derecha pueden influir en la capacidad de ejercicio en la insuficiencia cardíaca congestiva.
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