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慢性心力衰竭患者运动期间骨骼肌质量对通气和血流动力学变量的影响。

Influence of skeletal muscle mass on ventilatory and hemodynamic variables during exercise in patients with chronic heart failure.

作者信息

Costa Ricardo Vivacqua Cardoso, da Nóbrega Antônio Cláudio Lucas, Serra Salvador Manoel, Rego Salete, Wajngarten Mauricio

机构信息

Instituto do Coração do Hospital das Clinicas, FMUSP, São Paoulo, SP- Rio de Janeiro, RJ- Brasil.

出版信息

Arq Bras Cardiol. 2003 Dec;81(6):581-5, 576-80. doi: 10.1590/s0066-782x2003001400004. Epub 2004 Jan 28.

Abstract

OBJECTIVE

To assess the influence of skeletal muscle mass on ventilatory and hemodynamic variables during exercise in patients with chronic heart failure (CHF).

METHODS

Twenty-five male patients underwent maximum cardiopulmonary exercise testing on a treadmill with a ramp protocol and measurement of the skeletal muscle mass of their thighs by using magnetic resonance imaging. The clinically stable, noncachectic patients were assessed and compared with 14 healthy individuals (S) paired by age and body mass index, who underwent the same examinations.

RESULTS

Similar values of skeletal muscle mass were found in both groups (CHF group: 3863 874 g; S group: 3743 540 g; p = 0.32). Significant correlations of oxygen consumption in the anaerobic threshold (CHF: r = 0.39; P= 0.02 and S: r = 0.14; P = 0.31) and of oxygen pulse also in the anaerobic threshold (CHF: r = 0.49; P = 0.01 and S: r =0.12; P = 0.36) were found only in the group of patients with chronic heart failure.

CONCLUSION

The results obtained indicate that skeletal muscle mass may influence the capacity of patients with CHF to withstand submaximal effort, due to limitations in their physical condition, even maintaining a value similar to that of healthy individuals. This suggests qualitative changes in the musculature.

摘要

目的

评估骨骼肌质量对慢性心力衰竭(CHF)患者运动期间通气和血流动力学变量的影响。

方法

25名男性患者采用斜坡方案在跑步机上进行了最大心肺运动测试,并通过磁共振成像测量了他们大腿的骨骼肌质量。对临床稳定、无恶病质的患者进行评估,并与14名按年龄和体重指数配对的健康个体(S组)进行比较,这些健康个体也接受了相同的检查。

结果

两组的骨骼肌质量值相似(CHF组:3863±874g;S组:3743±540g;p = 0.32)。仅在慢性心力衰竭患者组中发现无氧阈下耗氧量(CHF组:r = 0.39;P = 0.02;S组:r = 0.14;P = 0.31)以及无氧阈下氧脉搏(CHF组:r = 0.49;P = 0.01;S组:r = 0.12;P = 0.36)之间存在显著相关性。

结论

所得结果表明,由于身体状况的限制,骨骼肌质量可能会影响CHF患者承受次最大运动强度的能力,即使其骨骼肌质量值与健康个体相似。这表明肌肉组织存在质性变化。

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