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静脈性心不全における運動振動呼吸:運動に対する血液動力学的反応の低下の指標である
Ryan M Murphy1, Ravi V Shah, Rajeev Malhotra
1Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
Circulation
|August 31, 2011
まとめ
心不全 (HF) の場合の運動振動換気 (EOV) は,運動中に心指数が低く,充填圧が高くなります. これは,EOVがHF患者における血液動力学的障害を示す可能性があることを示唆しています.
科学分野:
- 心臓病学 心臓病学
- 肺生理学 肺生理学とは
- 運動医学は,運動療法です.
背景:
- 運動振動呼吸 (EOV) は,心筋梗塞性心不全 (HF) の結果を予測する既知の指標です.
- 以前の研究では,運動中の侵入性血液動力学および血液ガスデータが限られているため,機械的洞察が欠けていました.
研究 の 目的:
- HF患者における運動中のEOVと侵襲的な血液動力学的測定との関係を調査する.
- EOVの予測要因とその心臓指数 (CI) と充填圧との関連を特定する.
主な方法:
- 56人のHF患者と19人の対照群は,インクリメンタル心肺運動テストを受けた.
- フィックの心臓の出力,充填圧,動脈の血液ガスを測定した.
- EOVは,HF患者の45%で検出されました.
主要な成果:
- 右心房圧が高くなり,肺毛細血管の圧が高くなり,心臓指数が低くなり,EOVが予測された.
- 低運動心筋指数は,EOVの最も強力な予測因子でした.
- EOVを患ったHF患者では,運動CIはEOVの幅度とサイクル長さに逆に関連していました.
結論:
- EOVは,HFにおける運動中に心指数が低下し,充填圧が上昇することと密接に関連しています.
- EOVは,HFにおける運動誘発性血動力学的障害の代理マーカーとして機能する可能性があります.
- EOVを有するHF患者におけるシルデナフィルの治療は,IC増加に比例して,EOV幅度とサイクル長さの減少につながった.
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