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周期性全身加速:一种治疗心血管疾病的新疗法。

Periodic whole body acceleration: a novel therapy for cardiovascular disease.

作者信息

Kohler M, Amann-Vesti B R, Clarenbach C F, Brack T, Noll G, Russi E W, Bloch K E

机构信息

Pulmonary Divison, Dept. of Internal Medicine, University Hospital of Zurich, Switzerland.

出版信息

Vasa. 2007 Nov;36(4):261-6. doi: 10.1024/0301-1526.36.4.261.

Abstract

BACKGROUND

Periodic whole body acceleration in the spinal axis (pGz) applied by a motion platform is a novel treatment modality that induced endothelial nitric oxide release into the circulation of animals, healthy subjects and patients with inflammatory diseases during single treatment sessions in previous studies. We hypothesized that patients with advanced arteriosclerotic diseases who are not candidates for a surgical intervention would clinically benefit from repeated pGz treatments over several weeks through improvement of endothelial function.

PATIENTS AND METHODS

11 patients, 5 men (37 to 71 y) with stable ischemic heart disease, LVEF < 35%, NYHA stage > II, and 6 patients (51 to 83 y, 1 woman) with intermittent leg claudication, Fontaine stage II, were enrolled after optimization of pharmacological therapy. PGz was applied for 40 min, 5 days/week during 5 weeks. Quality of life (SF-36 questionnaire), exercise performance, and endothelial function were assessed at baseline, during the treatment period, and 4 weeks after discontinuation of pGz.

RESULTS

PGz was well tolerated. In heart failure paitents, pGz therapy improved quality of life, increased 6 min walking distance by a mean +/- SE of 105 +/- 24 m, and improved postischemic skin hyperemia (p < .05 in all instances). In 4 of 6 patients with intermittent claudication, quality of life, treadmill walking distance and post-ischemic skin hyperemia improved with pGz therapy (p < .05). Four weeks after discontinuation of pGz, most therapeutic effects had vanished in both patient groups.

CONCLUSIONS

In patients with severe heart failure and with leg claudication who remain symptomatic despite maximal medical therapy and who were not candidates for surgery, periodic acceleration applied over several weeks improved quality of life and exercise capacity. The clinical benefits appear to be mediated through improved endothelial function.

摘要

背景

运动平台施加的脊柱轴周期性全身加速(pGz)是一种新型治疗方式,在先前的研究中,单次治疗期间可诱导内皮一氧化氮释放到动物、健康受试者和炎症性疾病患者的循环中。我们假设,对于不适合手术干预的晚期动脉粥样硬化疾病患者,通过改善内皮功能,在数周内重复进行pGz治疗将在临床上获益。

患者与方法

在优化药物治疗后,纳入11例患者,其中5例男性(37至71岁)患有稳定型缺血性心脏病,左心室射血分数(LVEF)<35%,纽约心脏协会(NYHA)心功能分级>II级;6例患者(51至83岁,1例女性)患有间歇性跛行,Fontaine分级II级。pGz治疗持续40分钟,每周5天,共5周。在基线、治疗期间以及停用pGz后4周评估生活质量(SF-36问卷)、运动能力和内皮功能。

结果

pGz耐受性良好。在心力衰竭患者中,pGz治疗改善了生活质量,6分钟步行距离平均增加了105±24米(均值±标准误),并改善了缺血后皮肤充血(所有情况下p<.05)。在6例间歇性跛行患者中的4例,pGz治疗改善了生活质量、跑步机行走距离和缺血后皮肤充血(p<.05)。停用pGz后4周,两组患者的大多数治疗效果均消失。

结论

对于严重心力衰竭和间歇性跛行患者,尽管接受了最大程度的药物治疗仍有症状且不适合手术,数周的周期性加速治疗改善了生活质量和运动能力。临床获益似乎是通过改善内皮功能介导的。

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