心力衰竭患者呼吸肌力量和肺功能的评估

Evaluation of respiratory muscle strength and pulmonary function in heart failure patients.

作者信息

Forgiarini Luiz Alberto, Rubleski Angélica, Douglas Garcia, Tieppo Juliana, Vercelino Rafael, Dal Bosco Adriane, Monteiro Mariane Borba, Dias Alexandre Simões

机构信息

Centro Universitário Metodista-IPA, Irmandade Santa Casa de Misecórdia de Porto Alegre, Fundação Faculdade Federal de Ciências Médicas de Porto Alegre, Porto Alegre, RS, Brasil.

出版信息

Arq Bras Cardiol. 2007 Jul;89(1):36-41. doi: 10.1590/s0066-782x2007001300007.

DOI:10.1590/s0066-782x2007001300007

PMID:17768581

Abstract

BACKGROUND

Heart failure (HF) is the inability of the heart to pump enough blood to supply the necessities of the body. Pulmonary function and respiratory muscles can be affected and typical symptoms presented by the patients include discomfort at a minimal exertion.

OBJECTIVE

To verify pulmonary function and respiratory muscle strength in patients with class II and III HF as defined by the New York Heart Association (NYHA).

METHODS

The study was descriptive and observational, and comprised 12 class II and III HF patients in follow-up at the out-patient. Pulmonary function assessments [Forced Expiratory Volume in the first second (FEV1) and Forced Vital Capacity (FVC)] were performed using microspirometry and respiratory muscle strength [Maximal Expiratory Pressure (MEPmax) and Maximal Inspiratory Pressure (MIPmax)] were evaluated using a pressure transducer (Globalmed).

RESULTS

Differences were found between the functional classes II and III in relation to pulmonary function: FEV1 (II: 91.17 +/- 19.87; III: 68.17 +/- 21.78); FVC (II: 68.17 +/- 21.78; III: 73.67 +/- 22.94); and respiratory muscle strength: MIPmax (II: 71.67 +/- 40.70; III: 53.33 +/- 29.27) and MEPmax (II: 98.83 +/- 34.56; III: 58.33 +/- 15.06). The class II were higher for all study parameters, only MEPmax revealed a statistically significant difference.

CONCLUSION

The pulmonary function and respiratory muscle strength are impaired in heart failure patients class III patients, particularly in relation to MEPmax.

摘要

背景

心力衰竭（HF）是指心脏无法泵出足够的血液以满足身体的需求。肺功能和呼吸肌可能会受到影响，患者出现的典型症状包括轻微活动时的不适。

目的

验证纽约心脏协会（NYHA）定义的II级和III级HF患者的肺功能和呼吸肌力量。

方法

本研究为描述性观察性研究，纳入了12例在门诊接受随访的II级和III级HF患者。使用微型肺活量计进行肺功能评估[第1秒用力呼气量（FEV1）和用力肺活量（FVC）]，并使用压力传感器（Globalmed）评估呼吸肌力量[最大呼气压力（MEPmax）和最大吸气压力（MIPmax）]。

结果

在肺功能方面，II级和III级功能分级之间存在差异：FEV1（II级：91.17±19.87；III级：68.17±21.78）；FVC（II级：68.17±21.78；III级：73.67±22.94）；以及呼吸肌力量：MIPmax（II级：71.67±40.70；III级：53.33±29.27）和MEPmax（II级：98.83±34.56；III级：58.33±15.06）。所有研究参数中II级均更高，只有MEPmax显示出统计学上的显著差异。