在心力衰竭患者中,在中央和外周化学受体刺激期间,神经血管控制异常,心脏衰竭患者的喷射分数保存
Yufuko Kataoka1, Allan R K Sales1,2,3, Amanda G Rodrigues1,4
1Faculdade de Medicina, Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 44, Cerqueira César, São Paulo, CEP 05403-904, Brazil.
保存喷射分数 (HFpEF) 的心力衰竭显示出过敏的化学受体,导致肌肉交感神经活动 (MSNA) 的增加. 这种自主性变化导致HFpEF患者血管收缩.
科学领域:
- 心血管生理学心血管生理学
- 自主神经系统调节自主神经系统调节
- 心脏衰竭病理生理学 病理生理学
背景情况:
- 减少射出分数 (HFrEF) 的心力衰竭与过敏化化学受体和肌肉交感神经活动 (MSNA) 的增加有关.
- 在心力衰竭中,保留喷射分数 (HFpEF) 的自主性变化仍然不太了解.
- 研究HFpEF中的化学反射控制对于理解其独特的病理生理学至关重要.
研究的目的:
- 测试这种假设,即中部和外围化学反射控制MSNA在HFpEF患者改变.
- 为了确定HFpEF患者是否表现出类似于HFrEF患者的过敏化疗受体.
- 阐明自主功能障碍在HFpEF中的作用.
主要方法:
- 包括9名患有HFpEF的患者 (年龄在55-80岁) 和9名年龄匹配的对照没有HFpEF.
- 通过低氧 (10% O2,定位的 CO2) 刺激了周围的化学受体,使用超 (7% CO2) 刺激了中央化学受体.
- 肌肉交感神经活动 (MSNA) 通过微神经图测量,前臂血流 (FBF) 通过囊图测量.
主要成果:
- 与对照组相比,低氧显著增加了HFpEF患者的MSNA和减少了FBF (分别p<0.001和p=0.006).
- 超也导致显著更高的MSNA和前臂下部血管导电 (FVC) 在HFpEF患者 (p<0.001和p=0.030,分别).
- 这些发现表明HFpEF中外周和中心化疗受体的反应加剧.
结论:
- 在HFpEF患者中,MSNA的外周和中央化学反射对照过敏.
- 这种过敏性可能有助于在HFpEF中观察到的MSNA升高.
- 在HFpEF中,化学受体刺激会诱导显著的肌肉血管收缩,突显出一个关键的自主性乱.
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