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急性低氧对慢性阻塞性肺疾病患者左、右心室收缩功能的影响

Effects of acute hypoxia on left and right ventricular contractility in chronic obstructive pulmonary disease.

作者信息

Akgül Ferit, Batyraliev Talantbek, Karben Zarema, Pershukov Igor

机构信息

Mustafa Kemal University, Faculty of Medicine, Antakya, Turkey.

出版信息

Int J Chron Obstruct Pulmon Dis. 2007;2(1):77-80. doi: 10.2147/copd.2007.2.1.77.

Abstract

The purpose of this investigation was to assess the effects of acute hypoxia on left (LV) and right ventricular (RV) contractility in clinically stable chronic obstructive pulmonary disease (COPD) patients. Eleven male patients (mean age 52.4 +/- 12.6 years) who were diagnosed to have COPD were included into the study. All of the patients underwent left and right heart catheterization. RV contractility was measured according to the method of Ferlinz and LV contractility according to the method of Kennedy and colleagues using indirect digital substraction angiography. Mean pulmonary artery pressures (Mean PPA) and oxygen saturation of the pulmonary artery (SaO2) were measured before and at each stage of graded hypoxic exposure 14%, 12%, and 10% of O2. Right atrial pressures (PRA,syst, PRA,diast, PRA,mean), RV pressures (PRV,syst, PRV,diast, PRV,mean, PRV,end-diast), RV and LV end-diastolic volume index (EDVI), end-systolic volume index (ESVI), stroke volume index (SVI), cardiac index (CI), ejection fraction (EF), and heart rate (HR) were calculated before and after breathing a hypoxic mixture of 10% of O2 for 30 minutes. Acute hypoxia induced significant elevation of mean PPA, PRA,syst, PRA,diast, PRA,mean, PRV,syst, PRV,mean, PRV,end-diast, RV EDVI, RV ESVI, LV EDVI, LV ESVI, confidence interval, and HR (p < 0.05). Whereas SaO2 decreased significantly after acute hypoxia (p < 0.05). These findings suggest that the systolic performance of the right and left ventricles were well-maintained during acute hypoxia in patients with COPD.

摘要

本研究的目的是评估急性低氧对临床稳定的慢性阻塞性肺疾病(COPD)患者左心室(LV)和右心室(RV)收缩力的影响。11名被诊断患有COPD的男性患者(平均年龄52.4±12.6岁)被纳入研究。所有患者均接受了左右心导管检查。采用Ferlinz方法测量右心室收缩力,采用Kennedy及其同事的方法通过间接数字减影血管造影测量左心室收缩力。在分级低氧暴露的每个阶段(14%、12%和10%的氧气)之前和期间测量平均肺动脉压(Mean PPA)和肺动脉血氧饱和度(SaO2)。计算在吸入10%氧气的低氧混合气30分钟前后的右心房压力(PRA,syst,PRA,diast,PRA,mean)、右心室压力(PRV,syst,PRV,diast,PRV,mean,PRV,end-diast)、右心室和左心室舒张末期容积指数(EDVI)、收缩末期容积指数(ESVI)、每搏量指数(SVI)、心指数(CI)、射血分数(EF)和心率(HR)。急性低氧导致Mean PPA、PRA,syst,PRA,diast,PRA,mean,PRV,syst,PRV,mean,PRV,end-diast、右心室EDVI、右心室ESVI、左心室EDVI、左心室ESVI、置信区间和HR显著升高(p<0.05)。而急性低氧后SaO2显著降低(p<0.05)。这些发现表明,COPD患者在急性低氧期间左右心室的收缩功能得到了良好维持。

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本文引用的文献

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Hypoxic vasoconstriction in pulmonary arterioles and venules.肺小动脉和小静脉中的缺氧性血管收缩。
J Appl Physiol (1985). 1997 Apr;82(4):1084-90. doi: 10.1152/jappl.1997.82.4.1084.

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