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使用运动压力回声仪监测运动诱导的腹腔内梯度的青少年的β阻塞疗法
Nuno Cotrim1, Hugo M Café2, Jorge Guardado3
1Hospital Distrital de Santarém, Avenida Bernardo Santareno, 3737B, 2005-177 Santarém, Portugal.
在青少年中,β抑制剂疗法有效降低或防止运动诱导的静脉内压梯度 (IVPG). 这种治疗也显著缓解了与运动相关的症状和心电图异常的发现.
科学领域:
- 儿童心脏病学
- 心血管生理学
- 药理学
背景情况:
- 跑步机运动应激回声 (ESE) 是儿童患者的安全和可行的诊断工具.
- 在青少年运动期间经常观察到静脉内压梯度 (IVPG),并提供了与运动相关的症状和心电图异常的见解.
- 区域壁运动异常 (RWMA) 在该人群中具有有限的诊断效用.
研究的目的:
- 评估β抑制剂治疗对有关症状或心电图发现的青少年IVPGs的影响.
- 评估β抑制剂在控制运动引起的血液动力学变化的有效性.
主要方法:
- 在最初接受IVPG的66名青少年中,重复进行运动应激心声扫描 (ESE).
- 在接受β- 阻断剂治疗期间,参与者进行了随访评估,休息时的回声图正常.
- 在基线和贝塔抑制剂治疗期间进行了全面的二维和多普勒评估.
主要成果:
- 在37名青少年中,β阻断剂治疗消除了IVPG或显著降低了IVPG (平均梯度从105±38 mmHg降低到58±32 mmHg).
- 在接受β抑制剂治疗时,运动心率的峰值从每分钟178±15降至每分钟157±9.
- 最初在47名青少年中出现的运动诱导的临床症状在治疗期间减少到7个.
结论:
- 在患有症状或心电图异常的青少年中,口服β抑制剂疗法有效预防或显著降低运动性IVPG.
- 得到的血动力学改善与显著的临床症状解消相关,在85%的有症状的青少年中观察到.
- 在此儿科队列中,β阻断剂治疗是治疗运动引起的心血管异常的一个有价值的策略.
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