慢性心不全における運動に対する呼吸器応答における右心室と左心室の機能の役割
1Department of Cardiac Medicine, National Heart and Lung Institute, London, UK.
Circulation
|May 1, 1994
まとめ
右心室機能は,慢性心不全患者の運動能力の重要な要因ではありません. 機能する右心室のない患者は,運動能力の低下と呼吸量の増加との関連を示しています.
科学分野:
- 心臓病学 心臓病学
- 運動生理学 運動生理学
- 肺動脈高血圧 肺動脈高血圧 肺動脈高血圧 肺動脈高血圧 肺動脈高血圧
背景:
- 右心室 (RV) 機能は,慢性心不全 (CHF) の運動能力の潜在的決定因子です.
- RV機能を理解することは,CHF患者における運動制限の管理に不可欠です.
研究 の 目的:
- CHFにおけるRV機能の役割を調査する.
- フォントン手術後の患者におけるRV備蓄の欠如が,運動能力と呼吸器応答に与える影響を調べる.
主な方法:
- 運動中の代謝ガス交換は,5つのグループで測定されました:フォントン患者 (機能性RVなし),拡張心筋病 (DCM) コントロール,正常コントロール,CHF患者,および追加のコントロール.
- 左心室と右心室のエジェクション分数 (LVEFとRVEF) は,放射性核素心室撮影を用いて,CHF患者で評価されました.
主要な成果:
- 機能的なRV (フォントン群) とDCM対照群の患者では,通常の対照群と比較して,換気/二酸化炭素生成 (VE/VCO2) の傾きが著しく高かった.
- 機能的なRVとDCMのコントロールを持たない患者で,ピーク酸素消費 (VO2) とVE/VCO2の傾きの間に強い逆相関が観察されました.
- CHF患者では,VE/VCO2の傾きが対照群より有意に高かったが,RVEFもLVEFもピークVO2またはVE/VCO2の傾きと相関しなかった.
結論:
- 過剰な換気と酸素消費のピークの減少との関係は,機能的な右心房が欠けている個体において明らかである.
- 右心室噴出分数 (RVEF) は,慢性心不全における運動能力や呼吸器の反応の主な決定因子ではないようです.
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