重度の心不全患者の前腕運動中の筋肉の血流

J M Arnold¹, J P Ribeiro, W S Colucci

¹University of Western Ontario, London, Canada.

Circulation

|August 1, 1990

まとめ

慢性心不全 (CHF) の筋肉の疲労は,運動している筋肉の血流の障害によるものではありません. 運動中の前腕の血流は,CHF患者と健康な個人の間で類似しており,正常な血管機能を示唆しています.

科学分野:

心血管生理学心血管の生理学
運動生理学運動生理学

背景:

筋肉の疲労は,慢性心不全 (CHF) の患者の一般的な症状です.
根本的な原因は,筋肉の血管系を鍛える血管拡張能力の異常を伴う可能性があります.

研究の目的:

筋疲労が運動中の局所的な血流調節の障害によるものかどうかを調査する.
重度のCHF患者の運動中の前腕血流 (FBF) を健康な対照群と比較するために.

主な方法:

メルキュール・イン・ゴム・ストレインゲージ・静脈プレチスモグラフィーを用いて,前腕の静止運動を15%,30%および最大自発的な収縮の45%で中断的に行う際に,FBFを研究した.
休息状態と運動中の測定は,13人のCHF患者と8人の健康な被験者に行われました.
CHFの患者は,静脈内ミルリノンの投与から24時間後に再評価されました.

主要な成果:

休息期FBFは,対照群と比較して,CHF患者で有意に低かった (p <0.05).
運動中に,FBFは,CHF患者と対照群の間で,どの強度でも有意に異なるものではありませんでした.
ピークエクササイズ時のFBFは,中枢静脈圧 (r = -0.65) と負の相関があり,右心室射出分数 (r = 0.59) と正の相関があった.

結論:

前腕の筋肉の血管系を鍛えるための血管拡張能力は,重度のCHFの患者では正常であるように見えます.
CHFにおける筋肉の疲労は,運動に対する局所血管応答の固有の異常から生じる可能性は低い.
中枢静脈圧や右心室機能などの血液動力学的要因は,心筋梗塞における運動能力に影響を与える可能性があります.

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