Suppr超能文献

[心脏肺功率在原发性肺动脉高压患者中的可能临床作用。初步观察]

[The possible clinical role of the cardiac pulmonary power in patients with primary pulmonary hypertension. Initial observations].

作者信息

Herrera Eulo Lupi, Zárate Julio Sandoval, Valenzuela Eduardo Chuquiure, Carrillo Arturo

机构信息

Instituto Nacional de Cardiología Ignacio Chávez, Tlalpan, México.

出版信息

Arch Cardiol Mex. 2006 Apr-Jun;76(2):140-50.

Abstract

The heart is a muscular mechanical pump with an ability to generate both flow [cardiac output] and pressure in the systemic circulation as well in the pulmonary vascular bed. The product of flow output and systemic arterial pressure is the rate of useful work done, or cardiac power output [CP], therefore for the right ventricle and the pulmonary arterial vascular bed it will be: the product of flow output and mean pulmonary arterial pressure will be the rate of useful work done, or cardiac pulmonary power output [CPP]. Cardiac pulmonary pumping reserve capability can be defined as the maximal cardiac pulmonary power output [CPP] achieved by the right heart during maximal stimulation. Therefore, CPP reserve is the increase in power output as the cardiac performance is increased from the resting to the maximally stimulated state. Recently, several studies have shown that CP is a direct indicator of overall cardiac function, as well is an indicator of exercise capacity and a powerful predictor of prognosis for patients with severe heart failure and ischemic cardiogenic shock. On this basis: 1. we decided to investigate the possible previously mentioned roles of the CP and CPP in patients with different degrees of pulmonary arterial hypertension [n = 137], but mainly in those with primary pulmonary arterial hypertension [PPH]. PPH patients [n = 50], as well as those with Eisenmenger's syndrome [n = 10] were found to have most abnormal resting CPP Indexes [I], [0.431 +/- 0.171, 0.607 +/- 0.124 watts/m2, respectively]. During exercise in PPH patients [n = 14], both CPI and CPPI reserves although they increase, were also found to be significantly diminished [CPI: from 0.546 +/- 170 to 1,116 +/- 0.275 watts/m2, p < 0.05], [CPPI: from 0.373 +/- 0.156 to 0.837 +/- 0.226 watts/m2, p < 0.05]. 2. We also found, significant differences in resting CPPI between PPH responders and no responders patients to hydralazine [0.273 +/- 0.04, 0.507 +/- 0.142 watts/m2, respectively, p < 0.01]. During exercise and under the influence of hydralazine, CPPI "reserve" was significantly diminished in those patients considered as not responders [0.507 +/- 0.142 to 0.723 +/- 0.232 watts/m2, p = ns] when compared with responders to the vasodilator therapy [0.273 +/- 0.04 to 0.903 +/- 0.057 watts/m2, p < 0.01]. On the basis of these initial findings on CPPI in PPH patients, we think that the values of this parameter should be investigated as an index for classifying the severity of this arterial vascular disease, for selecting patients as responders or not to vasodilator therapy, and in the future, to explore the possibility of is usefulness as a prognostic predictor index of mortality in a large population of patients with PPH.

摘要

心脏是一个肌肉性机械泵,能够在体循环以及肺血管床中产生血流(心输出量)和压力。心输出量与体循环动脉压的乘积是有用功的速率,即心脏功率输出(CP),因此对于右心室和肺动脉血管床而言,其乘积为:心输出量与平均肺动脉压的乘积将是有用功的速率,即心脏肺功率输出(CPP)。心脏肺泵血储备能力可定义为右心在最大刺激时所达到的最大心脏肺功率输出(CPP)。因此,CPP储备是指随着心脏功能从静息状态增加到最大刺激状态时功率输出的增加。最近,多项研究表明,CP是整体心脏功能的直接指标,也是运动能力的指标,并且是重度心力衰竭和缺血性心源性休克患者预后的有力预测指标。基于此:1. 我们决定研究CP和CPP在不同程度肺动脉高压患者(n = 137)中可能发挥的上述作用,主要是在原发性肺动脉高压(PPH)患者中。发现PPH患者(n = 50)以及艾森曼格综合征患者(n = 10)的静息CPP指数(I)最为异常,分别为0.431±0.171、0.607±0.124瓦/平方米。在PPH患者(n = 14)运动期间,尽管CPI和CPPI储备增加,但也发现显著降低(CPI:从0.546±0.170到1.116±0.275瓦/平方米,p < 0.05),(CPPI:从0.373±0.156到0.837±0.226瓦/平方米,p < 0.05)。2. 我们还发现,对肼屈嗪有反应和无反应的PPH患者静息CPPI存在显著差异(分别为0.273±0.04、0.507±0.142瓦/平方米,p < 0.01)。在运动期间以及在肼屈嗪的影响下,与血管扩张剂治疗有反应的患者相比,被视为无反应的患者的CPPI“储备”显著降低(从0.507±0.142到0.723±0.232瓦/平方米,p =无显著性差异),而有反应的患者为(从0.273±0.04到0.903±0.057瓦/平方米,p < 0.01)。基于这些关于PPH患者CPPI的初步发现,我们认为该参数的值应作为对这种动脉血管疾病严重程度进行分类、选择血管扩张剂治疗有反应或无反应患者的指标进行研究,并且在未来,探索其作为大量PPH患者死亡率预后预测指标的有用性。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验