Ravi Krishnan, Kappagoda Tissa
Respir Physiol Neurobiol. 2009 May 30;167(1):107-15. doi: 10.1016/j.resp.2008.10.002. Epub 2008 Oct 11.
Acute heart failure is associated with dyspnea that is usually defined as difficulty in breathing that is accompanied by an element of distress. It is commonly associated with an increase in the rate of ventilation, wheezing, an increase in airway secretions and cough. This review examines the reflexes which generate these responses with particular reference to the role of rapidly adapting receptors (RAR) in the airways. The essential feature of acute heart failure is an increase in pulmonary extravascular fluid volume. Small acute increases in extravascular fluid volume in the airways activate the RAR. With larger increases both the RAR and the C-fiber receptors in the airways and the alveoli are activated. Activation of RAR causes a reflex increase in respiratory rate, tracheal tone and mucus secretion from the airways. It is suggested that the RAR play a significant role in monitoring changes in the extravascular fluid volume of the airways and mediate the respiratory reflexes associated with acute heart failure.
急性心力衰竭常伴有呼吸困难，通常将其定义为呼吸困难并伴有某种程度的不适。它通常与通气频率增加、喘息、气道分泌物增多及咳嗽有关。本综述探讨引发这些反应的反射，尤其关注气道中快速适应感受器（RAR）的作用。急性心力衰竭的基本特征是肺血管外液体量增加。气道中血管外液体量的小幅度急性增加会激活RAR。当增加幅度更大时，气道和肺泡中的RAR及C纤维感受器都会被激活。RAR的激活会引起呼吸频率、气管张力及气道黏液分泌的反射性增加。有人认为，RAR在监测气道血管外液体量的变化及介导与急性心力衰竭相关的呼吸反射中起重要作用。
