Mtinangi B L, Hainsworth R
Institute for Cardiovascular Research, University of Leeds, UK.
Heart. 1998 Dec;80(6):596-600. doi: 10.1136/hrt.80.6.596.
To determine whether a programme of simple, moderate exercise training increases blood volume and improves orthostatic tolerance in patients with attacks of syncope or near syncope related to orthostatic stress.
An open study in 14 patients referred with unexplained attacks of syncope, who were shown to have a low tolerance to an orthostatic stress test. Measurements were made of plasma and blood volumes, orthostatic tolerance to a test of combined head up tilt and lower body suction, and baroreceptor sensitivity by applying subatmospheric pressures to a chamber over the neck. Cardiorespiratory fitness was assessed from the relation between heart rate and oxygen uptake during a graded treadmill exercise test. Assessments were made before and after undertaking an exercise training programme (Canadian Air Force 5BX/XBX).
After the training period, 12 of the 14 patients showed evidence of improved cardiorespiratory fitness. All 12 patients were symptomatically improved; they showed increases in plasma and blood volumes and in orthostatic tolerance, and decreases in baroreceptor sensitivity. Despite the improved orthostatic tolerance, values of blood pressure both while supine and initially following tilting were lower than before training.
Exercise training has a role in the management of patients with syncope and poor orthostatic tolerance. It improves symptoms and increases orthostatic tolerance without increasing resting blood pressure.
确定一项简单的适度运动训练方案是否能增加与体位性应激相关的晕厥或接近晕厥发作患者的血容量并改善体位性耐受性。
对14例因不明原因晕厥发作前来就诊且被证明对体位性应激试验耐受性低的患者进行的一项开放性研究。测量了血浆和血容量、对头部抬高倾斜和下体吸引联合试验的体位性耐受性，以及通过对颈部上方腔室施加低于大气压的压力来测量压力感受器敏感性。通过在分级跑步机运动试验期间心率与摄氧量之间的关系评估心肺适能。在进行运动训练方案（加拿大空军5BX/XBX）之前和之后进行评估。
训练期后，14例患者中有12例显示心肺适能改善的证据。所有12例患者症状均有改善；他们的血浆和血容量增加，体位性耐受性增加，压力感受器敏感性降低。尽管体位性耐受性有所改善，但仰卧位时以及最初倾斜后的血压值均低于训练前。
运动训练在晕厥和体位性耐受性差的患者管理中具有作用。它改善症状并增加体位性耐受性，而不增加静息血压。
