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在患有慢性阻塞性肺病和心力衰竭同时存在的患者中练习振荡通风:临床影响
Cássia da Luz Goulart1, Rebeca Nunes Silva1, Piergiuseppe Agostoni2
1Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Sao Carlos, SP, Brazil.
Respiratory medicine
|June 25, 2023
概括
运动振荡通风 (EOV) 表明心力衰竭严重,排气率降低和COPD. 患有EOV的患者面临更高的死亡风险,突出其预后价值.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 运动生理学 运动生理学
背景情况:
- 运动振荡通风 (EOV) 是心力衰竭预后不佳的已知预测因子之一,心力衰竭的预测因子是心力衰竭与减少喷射率 (HFrEF).
- 在患有慢性阻塞性肺病 (COPD) 和HFrEF并存的患者中,EOV的存在和影响仍未研究.
研究的目的:
- 在心肺运动测试 (CPET) 期间,比较HFrEF-COPD患者在心肺运动测试 (CPET) 中具有和没有EOV的临床特征.
- 确定EOV对HFrEF-COPD患者35个月死亡率的影响.
主要方法:
- 50名稳定的HFrEF-COPD患者 (排泄分数<50%) 接受了CPET.
- 参与者被跟踪了35个月.
- 统计分析包括t测试,奇平方测试,线性回归和卡普兰-梅尔分析.
主要成果:
- 13% (26%) 的参与者表现出EOV.
- 与非EOV组相比,EOV组的心脏功能 (LVEF),肺功能 (FEV1) 显著恶化,死亡率更高.
- EOV与更高的分钟通风/二氧化碳生产斜率,减少峰值通风和较低的峰值氧气吸收有关.
结论:
- 在HFrEF-COPD患者中,EOV的存在与疾病严重程度的增加有关.
- 在这种患者群体中,EOV作为临床状态和预后的重要生物标志物.
- 为了改善HFrEF-COPD患者的管理和风险分层,可能需要对EOV进行评估.
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