在Fontan手术后,心脏自主神经活动严重受损
H Ohuchi1, S Hasegawa, K Yasuda
1Department of Pediatrics, National Cardiovascular Center, Osaka, Japan. hohuchi@hsp.ncvc.go.jp
Circulation
|September 26, 2001
概括
在Fontan手术后,心脏自主神经活动 (CANA) 受到损害,副交感神经活动 (PSNA) 和交感标志物减少. 这种自主功能障碍可能源于Fontan循环本身,而不是通过ACE抑制剂得到改善.
科学领域:
- 心脏病学 心脏病学
- 自主神经科学 自主神经科学
- 儿科心脏手术 儿科心脏手术
背景情况:
- 芬坦手术后的患者表现出神经气活动升高和异常的运动心肺反应.
- 在Fontan后的患者中,心脏自主神经活动 (CANA) 仍未得到充分研究.
研究的目的:
- 在Fontan手术后的患者中评估心脏自主神经活动 (CANA).
- 调查CANA,运动能力和Fontan后患者的临床特征之间的关系.
主要方法:
- 使用心率变化,巴罗反射灵敏度和[123I]metaiodobenzylguanidine成像 (H/M比) 来评估CANA.
- 通过HR增加测量心脏交感神经活动在异二醇 (β) 和运动能力 (峰值VO2) 后.
- 将63名Fontan后患者与44名对照人进行比较,分析与临床参数的相关性.
主要成果:
- 与对照组相比,Fontan后的患者表现出显著较低的心脏副交感神经活动 (PSNA) 和H/M比率.
- 贝塔敏感性和PSNA与运动期间心率增加相关 (DeltaHR),但DeltaHR与峰值VO2无关.
- 在CANA标记物 (PSNA,H/M) 与临床特征或手术史之间没有发现任何关联.
结论:
- 后突触β-敏感性和PSNA保持,并有助于运动诱导的心率变化后Fontan,虽然不确定运动能力.
- 独立于手术因素的Fontan循环本身可能会损害CANA.
- ангиотензин转化酶抑制剂治疗没有改善观察到的自主功能障碍.
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