规律的体育锻炼可改善心脏移植受者的内皮功能。

Regular physical exercise improves endothelial function in heart transplant recipients.

作者信息

Schmidt Alice, Pleiner Johannes, Bayerle-Eder Michaela, Wiesinger Günther F, Rödler Suzanne, Quittan Michael, Mayer Gert, Wolzt Michael

机构信息

Department of Clinical Pharmacology, University of Vienna, Austria.

出版信息

Clin Transplant. 2002 Apr;16(2):137-43. doi: 10.1034/j.1399-0012.2002.1o100.x.

DOI:10.1034/j.1399-0012.2002.1o100.x

PMID:11966784

Abstract

BACKGROUND

Impaired endothelial function is detectable in heart transplant (HTX) recipients and regarded as risk factor for coronary artery disease. We have studied whether endothelial function can be improved in HTX patients participating in a regular physical training program as demonstrated in patients with chronic heart failure, hypertension and coronary artery disease.

METHODS

Male HTX patients and healthy, age-matched controls were studied. Seven HTX patients (age: 60 +/- 6 yr; 6 +/- 2 yr of HTX) participated in an outpatient training program, six HTX patients (age: 63 +/- 8 yr; 7 +/- 1 yr of HTX) maintained a sedentary lifestyle without regular physical exercise since transplantation. A healthy control group comprised six subjects (age: 62 +/- 6 yr). Vascular function was assessed by flow-mediated dilation of the brachial artery (FMD). Systemic haemodynamic responses to intravenous infusion of the endothelium independent vasodilator sodium nitroprusside (SNP) and to NG-monomethyl-L-arginine (L-NMMA), an inhibitor of constitutive nitric oxide synthase, were also measured.

RESULTS

Resting heart rate was significantly lower (p < 0.05) in healthy controls (66 +/- 13) than in the HTX training group (83 +/- 11) and in non-training HTX patients (91 +/- 9), baseline blood pressure also tended to be lower in healthy subjects and in the training HTX patients. FMD was significantly higher (p < 0.05) in the control group (8.4 +/- 2.2%) and in the training group (7.1 +/- 2.4%), compared with non-training HTX patients (1.4 +/- 0.8%). The response of systolic blood pressure (p = 0.08) and heart rate (p < 0.05) to L-NMMA was reduced in sedentary HTX patients compared with healthy controls and heart rate response to SNP was also impaired in sedentary HTX patients.

DISCUSSION

Regular aerobic physical training restores vascular function in HTX patients, who are at considerable risk for developing vascular complications. This effect is demonstrable in conduit and systemic resistance arteries.

摘要

背景

心脏移植（HTX）受者存在内皮功能受损的情况，且被视为冠状动脉疾病的危险因素。我们研究了参与常规体育锻炼计划的HTX患者的内皮功能是否能像慢性心力衰竭、高血压和冠状动脉疾病患者那样得到改善。

方法

对男性HTX患者和年龄匹配的健康对照者进行研究。7名HTX患者（年龄：60±6岁；HTX术后6±2年）参加了门诊训练计划，6名HTX患者（年龄：63±8岁；HTX术后7±1年）自移植后保持久坐不动的生活方式，未进行规律体育锻炼。一个健康对照组由6名受试者（年龄：62±6岁）组成。通过肱动脉血流介导的扩张（FMD）评估血管功能。还测量了静脉输注内皮依赖性血管扩张剂硝普钠（SNP）以及一氧化氮合酶抑制剂NG-单甲基-L-精氨酸（L-NMMA）时的全身血流动力学反应。

结果

健康对照组（66±13）的静息心率显著低于HTX训练组（83±11）和非训练HTX患者（91±9）（p<0.05），健康受试者和训练HTX患者的基线血压也往往较低。与非训练HTX患者（1.4±0.8%）相比，对照组（8.4±2.2%）和训练组（7.1±2.4%）的FMD显著更高（p<0.05）。与健康对照组相比，久坐不动的HTX患者对L-NMMA的收缩压反应（p = 0.08）和心率反应（p<0.05）降低，久坐不动的HTX患者对SNP的心率反应也受损。