心脏移植后运动能力和慢性反应能力的长期连续变化
M M Givertz1, L H Hartley, W S Colucci
1Cardiomyopathy Program, Brigham and Women's Hospital, Boston, Mass., USA.
Circulation
|July 1, 1997
概括
心脏移植接受者在手术后一年表现出改善的运动能力. 然而,心率反应仍然异常,长达五年的时间内,慢性反应能力或运动能力没有显著改善. 这表明,在移植后,心脏功能有限的心脏再内核发生.
科学领域:
- 心脏病学 心脏病学
- 移植医学 移植医学
- 运动生理学 运动生理学
背景情况:
- 整形心脏移植可以提前改善峰值运动能力.
- 然而,运动期间的心率 (HR) 响应仍然异常,原因是心脏缩,其特点是心率上升的减少和不正常的峰值运动HR.
- 这项研究调查了心脏再内尔化是否会随着时间的推移改善慢性反应和运动能力.
研究的目的:
- 评估心脏移植后对运动和最大运动能力的慢性反应的长期变化.
- 为了确定心脏再内尔化是否发生并改善心脏对运动的生理反应,在移植后的1至5年之间进行.
主要方法:
- 对57名心脏移植患者进行了连续高峰症状限制心肺运动试验的回顾性分析,移植后长达5年的时间.
- 与33名没有心脏病的对照患者进行比较,以及41名患者的移植前数据.
- 评估峰值氧气消耗,峰值运动HR和HR从休息到峰值运动的增加.
主要成果:
- 移植后一年,与移植前水平相比,峰值氧气消耗增加了43%.
- 与对照组相比,最大运动能力和HR对运动的反应仍然低于正常水平.
- 在移植后的5年内,在峰值运动能力,峰值运动HR或HR增加方面没有进一步的改善.
结论:
- 心脏移植后的一年,峰值运动能力和慢性反应能力是不理想的.
- 移植后1至5年间,这些参数没有显著改善.
- 在这个时间范围内,功能性显著的心脏再内核似乎没有发生,这表明持续的慢性无能.
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