保持了同情反应性,但对静态手握运动的压力响应减弱,在心力衰竭中与保存的射出分数保持心力衰竭
Takuro Washio1,2, Ryosuke Takeda1,2, Sarah L Hissen1,2
1Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 7232 Greenville Avenue, Dallas, TX, 75231, USA.
概括
患有心力衰竭的患者保留喷射分数 (HFpEF) 显示在静态手握运动期间血压反应. 然而,它们在运动和代谢反射激活期间的交感神经反应性仍然完好无损.
科学领域:
- 心血管生理学心血管生理学
- 运动生理学 运动生理学
- 心脏衰竭研究研究
背景情况:
- 在静态手握 (SHG) 期间观察到心力衰竭与保留射出分数 (HFpEF) 时,血压 (BP) 响应变得麻木.
- 这种麻木可能源于交感反应的改变或肌肉代谢反射功能的损伤.
- 对于SHG和HFpEF中孤立的代谢反射激活的特定交感神经反应尚不清楚.
研究的目的:
- 研究是否对SHG和运动后循环阻塞 (PECO) 诱导的代谢反射激活的交感神经反应在HFpEF患者中减弱.
- 为了比较HFpEF患者和对照者之间的运动和代谢反射激活期间的血压,心率 (HR) 和肌肉交感神经活动 (MSNA) 反应.
主要方法:
- 39名HFpEF患者和24名年龄匹配的对照在40%的最大自愿收缩时进行了卧底SHG以致疲劳.
- 在SHG和随后的2分钟PECO期间,持续监测BP,HR和MSNA.
- 分析的重点是平均动脉压 (MAP),HR和MSNA参数的变化.
主要成果:
- 与对照组相比,HFpEF患者在SHG和PECO期间的静止平均动脉压 (MAP) 较低,MAP的峰值增加较小.
- 虽然休息HR在HFpEF中较高,但SHG期间的峰值HR在不同组之间没有差异.
- 尽管在HFpEF中休息时MSNA爆发频率较高,但MSNA对SHG或PECO的反应在两组之间没有显著差异.
结论:
- 患有HFpEF的患者在疲劳性SHG期间表现出保留的交感神经反应,尽管压力反应减弱.
- 通过PECO评估的肌肉代谢反射激活似乎很小,并且在HFpEF患者和对照人群之间没有显著差异.
- 这些发现表明,HFpEF中压力反应的减弱并不是由于交感神经外流受损,而是可能涉及其他调节机制.
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