在患有心力衰竭的患者中,在休息状态和冷压测试期间的交感神经控制与保存的喷射分数
Ryosuke Takeda1,2, Sarah L Hissen1,2, John D Akins1,2
1Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital Dallas (R.T., S.L.H., J.D.A., T.W., C.M.H., J.P.M., S.S., B.D.L., Q.F.).
患有心力衰竭和保留射出分数 (HFpEF) 的患者表现出更高的休息交感神经活动,但降低了巴罗反射灵敏度. 它们对寒冷压力的血压反应是麻木的,这表明血管收缩受损,尽管同情反应能力完好无损.
科学领域:
- 心血管生理学心血管生理学
- 自主神经系统功能 自主神经系统功能
- 心脏衰竭研究研究
背景情况:
- 保存喷射分数 (HFpEF) 的心力衰竭与自主功能障碍有关.
- 肌肉交感神经活动 (MSNA) 在血压调节中起作用.
- 巴罗反射灵敏度调节MSNA和血压.
研究的目的:
- 与对照人群相比,研究HFpEF患者的静止MSNA和同情反应性.
- 为了评估HFpEF患者的同情性巴罗反射灵敏度.
- 为了确定HFpEF患者在冷压器试验中是否表现出改变的同情反应.
主要方法:
- 微神经图用于测量28名HFpEF患者和44名对照患者的MSNA.
- 血压,心率和MSNA被记录在休息状态和冷压器测试期间.
- 评估了自发的同情性巴罗反射灵敏度.
主要成果:
- HFpEF患者的静止MSNA爆发频率较高 (P=0.020) 和交感巴罗反射灵敏度降低 (P=0.019).
- 在冷压器试验期间的MSNA反应性在各组之间没有差异 (P=0.135-0.998).
- 与对照组相比,HFpEF患者在冷压器测试中表现出压缩血压的增加较小 (P<0.001).
结论:
- HFpEF患者的休息交感神经活动增加,交感巴罗反射敏感性受损.
- 在寒冷压力期间,交感反应性被保留,但血管收缩反应可能会减弱.
- 这些发现表明,在HFpEF中的交感血管收缩中,潜在的外周通路受损.
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