在患有慢性心力衰竭和中央睡眠呼吸暂停的患者中,增强了对运动的呼吸反应
Michael Arzt1, Martina Harth, Andreas Luchner
1Klinik und Poliklinik für Innere Medizin II, Universität Regensburg, Germany. michael.arzt@klinik.uni-regensburg.de
Circulation
|April 16, 2003
概括
在慢性心力衰竭患者中,中央睡眠呼吸暂停与运动期间呼吸系统反应增加有关. 这表明增加对二氧化碳的化学敏感性是这两种情况的共同机制.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 睡眠医学 睡眠医学
背景情况:
- 中央睡眠呼吸暂停 (CSA) 和增强的呼吸反应 (VE / VCO2斜率) 在慢性心力衰竭 (CHF) 中很常见.
- 这两种情况都与CHF患者的预后不佳有关.
- 增加对CO2的化学敏感性是一种可疑的常见机制,但CHF中CSA和VE/VCO2斜率之间的关系尚不清楚.
研究的目的:
- 研究慢性心力衰竭 (CHF) 患者中中枢睡眠呼吸暂停 (CSA) 和呼吸系统对运动反应 (VE/VCO2斜率) 的关系.
主要方法:
- 将20名患有临床显著CSA的CHF患者 (呼吸暂停-呼吸暂停指数>或=15) 与没有CSA的10名CHF患者进行了比较.
- 使用心肺运动测试来确定VE/VCO2斜率和运动能力 (峰值VO2).
- 评估左心室喷射率 (LVEF) 和呼吸暂停-呼吸暂停指数 (AHI).
主要成果:
- 患有和没有CSA的患者在运动能力 (峰值VO2) 或LVEF方面没有显著差异.
- 呼吸暂停-呼吸暂停指数 (AHI) 与峰值VO2或LVEF没有相关性.
- 在VE/VCO2斜率和AHI (P<0.001) 之间发现了高度显著的正相关性.
- 在患有CSA的CHF患者中,VE/VCO2斜率明显高于没有CSA的患者 (29.7对24.9,P<0.001).
结论:
- 患有CSA的CHF患者与没有CSA的患者相比,对运动的呼吸反应显著增加.
- 与峰值VO2和LVEF不同的是,VE/VCO2斜率与CHF中CSA严重程度密切相关.
- 这些发现支持增加对二氧化碳的化学敏感性作为一种共同的病理生理机制,它是CSA和CHF中增强呼吸器反应的基础.
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