在高海拔地区发现不明原因的喘息障碍的原因,使用与心声学相结合的常态性缺氧
Jan Stepanek1, Juan M Farina2, Ahmed K Mahmoud2
1Aerospace Medicine Program, Department of Internal Medicine, Mayo Clinic, Scottsdale, AZ 85054, USA.
在低氧模拟测试期间的胸外回声心脏成像揭示了右心室功能障碍和偏移,解释了高海拔呼吸障碍. 这种方法可以确定为什么有些人在海拔高度出现严重症状.
科学领域:
- 心血管生理学心血管生理学
- 高度医学 高度医学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 高空暴露会导致低性缺氧,导致心血管变化和呼吸障碍和疲劳等症状.
- 个人对高海拔症状的易感性各不相同,根本原因往往不清楚.
- 低氧模拟测试 (HST) 通过让患者呼吸低氧气混合物来模拟高海拔生理学.
研究的目的:
- 在HST期间评估横胸心声学 (TTE) 检测右侧压力增加.
- 评估缺氧对右心室 (RV) 血液动力学和右到左的变速器的影响.
- 为了确定高海拔症状的潜在原因.
主要方法:
- 对27名患有不明原因高海拔呼吸障碍的患者进行了回顾性研究.
- 通过给予降低的FiO2来模拟患者特定的高度水平来执行HST.
- 在基线和峰值低氧期间获得的心声图 (包括TTE).
主要成果:
- 在缺氧期间,RV静脉缩压增加,RV静脉缩功能下降 (TAPSE,S'波,RV自由壁应变减少).
- 在70.4%的患者中,通过泡对比注射检测到右向左的分流.
- 在42.1%的受影响患者中,缺氧期间变节的严重程度增加,而36.8%的患者在缺氧期间只有明显的变节.
结论:
- 在HST期间的TTE有效地揭示了高海拔呼吸障碍患者的症状分流和RV血液动力下降.
- 这种方法有助于解释高度相关症状的生理基础.
- 需要进一步的研究来确定TTE在HST中的临床实用性.
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