在右心室外流管重建后的患者中,运动后心血管恢复的异常及其决定因素
Hideo Ohuchi1, Hiroyuki Ohashi, Jiksoo Park
1Department of Pediatrics, National Cardiovascular Center, Suita, Osaka, Japan. hohuchi@hsp.ncvc.go.jp
Circulation
|November 27, 2002
概括
在右心室外流通道重建 (RVOTR) 后的患者在运动后心血管恢复延迟. 这与自主神经系统功能障碍和血液动力学变化有关,影响心率和氧气吸收恢复.
科学领域:
- 心脏病学 心脏病学
- 儿童心脏病学 儿童心脏病学
- 心血管生理学心血管生理学
背景情况:
- 遗传性心脏缺陷通常需要手术修复,例如右心室外流通道重建 (RVOTR).
- 在RVOTR后的患者在运动期间表现出异常的心率 (HR) 和氧气吸收 (VO2) 反应.
- 在这些患者中,运动后心血管恢复的动态尚不清楚.
研究的目的:
- 与对照组相比,研究RVOTR后患者的运动后心血管恢复.
- 确定影响RVOTR后心血管恢复延迟的因素.
主要方法:
- 评估了52名心房隔膜缺陷关闭后患者 (A组),79名RVOTR后患者 (B组) 和44名对照患者.
- 测量了HR变异性,动脉巴罗反射灵敏度 (BRS),血北上腺素和血液动力学.
- 评估了运动后的HR,VO2和缩血压 (SBP) 的下降.
主要成果:
- 与A组和对照组相比,B组 (RVOTR) 在运动后显示HR和VO2的延迟下降,并在运动高峰后延迟SBP下降.
- 年龄,低频率HR变异性,以及血中诺氨基独立地预测了HR早期下降.
- BRS,体重和右心室喷射分数影响了SBP早期的下降,而BRS,肺动脉阻力,年龄和右心室缩压影响了VO2的下降.
结论:
- 对于RVOTR患者来说,运动后心血管恢复的延迟.
- 手术诱导的自主神经系统功能障碍和血液动力学障碍显著影响恢复.
- 代谢和自主成熟,以及手术因素,对于理解恢复模式至关重要.
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