在心力衰竭患者的运动期间,呼吸系统症状的感知与保存的喷射分数心力衰竭患者
Josh T Goh1, Bryce N Balmain1, Andrew R Tomlinson1
1Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA; Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Respiratory physiology & neurobiology
|April 7, 2024
概括
在心力衰竭中,保留喷射分数 (HFpEF),中心或外围限制不会改变呼吸困难或负面情绪. 运动性呼吸障碍 (DOE) 与共同的机制有关,而不是特定的限制.
科学领域:
- 心脏病学 心脏病学
- 呼吸系统医学 呼吸系统医学
- 运动生理学 运动生理学
背景情况:
- 保存喷射分数 (HFpEF) 的心力衰竭的特征是心脏功能受损.
- 疲劳性呼吸障碍 (DOE) 是HFpEF患者常见和衰弱的症状.
- 了解DOE的生理基础对于改善患者管理至关重要.
研究的目的:
- 为了确定氧气吸收的中心或外围限制是否会在HFpEF中对呼吸道感觉产生不同的影响.
- 调查HFpEF中的DOE是否与不愉快和负面情绪有关.
- 在HFpEF中探索DOE,呼吸道感觉和情绪反应之间的关系.
主要方法:
- 48名HFpEF患者被分为中心 (n=15) 或外围 (n=33) 限制,基于心脏输出/氧气吸收斜率和在增量循环期间的中风体积储备.
- 在20W循环测试中,使用博格尺度评估感知呼吸困难 (RPB) 和不愉快感 (RPU) 的评级.
- 患者随后评价了15个呼吸感觉陈述和5个负面情绪陈述.
主要成果:
- 在中心和外围限制组之间,没有发现RPB,呼吸道感觉或负面情绪的显著差异 (p>0.05).
- RPB与RPU (r=0.925),焦虑 (r=0.610) 和恐惧 (r=0.383) (p<0.05) 有很强的相关性.
- 虽然DOE引起了强烈的负面情绪,但这种感觉本身似乎与HFpEF的共同机制有关,而不是特定的中央或外围限制.
结论:
- 在HFpEF中,中央和外围的限制似乎没有明显地影响呼吸道感觉或情绪反应.
- 在HFpEF中,疲劳性呼吸障碍与显著的不愉快和负面情绪有关.
- 这些发现表明,DOE和HFpEF中相关的感觉存在一个共同的潜在机制,不管主要的限制部位如何.
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