Krzemiński K, Cybulski G, Nazar K
Department of Applied Physiology, Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland.
Clin Physiol Funct Imaging. 2009 Apr;29(2):114-22. doi: 10.1111/j.1475-097X.2008.00842.x.
Our previous study showed elevation of plasma adrenomedullin (ADM) during static handgrip in patients with heart failure (HF). It is hypothesized that ADM increases with left ventricle dysfunction during handgrip and thus plays a compensatory role. In the present study pre-ejection period (PEP) and left ventricular ejection time (LVET) were used to assess cardiac performance in 24 male HF patients (II/III class NYHA) during two 3-min bouts of handgrip at 30% of maximal voluntary contraction (MVC) performed alternately with each hand without any break between the bouts. Plasma ADM, noradrenaline (NA), adrenaline (A), heart rate (HR), blood pressure (BP) and stroke volume (SV) were determined. During handgrip plasma ADM, NA, A, HR, BP, PEP/LVET increased, PEP was prolonged and LVET shortened. The increases in plasma ADM correlated with changes in: PEP (r = -0.881), LVET (r = 0.713), PEP/LVET (r = -0.769), SV (r = 0.836), diastolic BP (r = 0.700), total peripheral resistance (TPR) (r = 0.718) and noradrenaline (r = 0.756). The study demonstrated that in HF patients changes in plasma ADM during handgrip are related to cardiac performance.
我们之前的研究表明，心力衰竭（HF）患者在静态握力试验期间血浆肾上腺髓质素（ADM）水平升高。据推测，握力试验期间ADM随着左心室功能障碍而增加，从而发挥代偿作用。在本研究中，采用射血前期（PEP）和左心室射血时间（LVET）来评估24例男性HF患者（纽约心脏协会II/III级）的心脏功能，他们在最大自主收缩（MVC）的30%水平下进行两次3分钟的握力试验，双手交替进行，两次试验之间无休息间隔。测定了血浆ADM、去甲肾上腺素（NA）、肾上腺素（A）、心率（HR）、血压（BP）和每搏输出量（SV）。握力试验期间，血浆ADM、NA、A、HR、BP、PEP/LVET升高，PEP延长，LVET缩短。血浆ADM的升高与以下指标的变化相关：PEP（r = -0.881）、LVET（r = 0.713）、PEP/LVET（r = -0.769）、SV（r = 0.836）、舒张压（r = 0.700）、总外周阻力（TPR）（r = 0.718）和去甲肾上腺素（r = 0.756）。该研究表明，HF患者握力试验期间血浆ADM的变化与心脏功能有关。
