Podoleanu Cristian, Maggi Roberto, Oddone Daniele, Solano Alberto, Donateo Paolo, Croci Francesco, Carasca Emilian, Ginghina Carmen, Brignole Michele
Cardiology Department, 4th Medical Clinic, University of Medicine and Pharmacy Targu Mures, Str. Gh. Marinescu 1, 540099, Targu Mures, Romania.
J Interv Card Electrophysiol. 2009 Nov;26(2):143-9. doi: 10.1007/s10840-009-9429-0. Epub 2009 Aug 8.
We investigated the hemodynamic mechanisms underlying the syndrome of delayed orthostatic hypotension (OH) and the hemodynamic effect of the treatment with leg compression bandages.
Non-invasive monitoring of systolic blood pressure (SBP), heart rate (HR), cardiac output (CO), stroke volume (SV), and total peripheral resistance (TPR) was performed during tilt testing in patients affected by delayed OH compared to age- and sex-matched controls. Thirteen patients (68 +/- 14 years) and nine controls (68 +/- 8 years) were studied.
Immediately after tilt-up, SBP progressively decreased in patients but not in controls. Symptoms developed at 100 +/- 7 mmHg. At the end of the test, SBP was significantly lower in patients than in controls. TPR progressively decreased in patients but not in controls. SV and CO did not change significantly. HR increased progressively in the patients until the end of the test and remained unchanged in controls. Active treatment with compression bandages avoided the decrease in SBP and TPR, while CO showed minimal variation.
In patients affected by delayed OH, the progressive decrease of SBP is associated with progressive decrease of TPR, while CO and SV show little variation; the compensatory increase in HR is insufficient to compensate for the decline in blood pressure.
我们研究了延迟性直立性低血压（OH）综合征背后的血流动力学机制以及腿部加压绷带治疗的血流动力学效应。
在倾斜试验期间，对延迟性OH患者与年龄和性别匹配的对照组进行无创监测收缩压（SBP）、心率（HR）、心输出量（CO）、每搏输出量（SV）和总外周阻力（TPR）。研究了13例患者（68±14岁）和9例对照组（68±8岁）。
上斜后立即，患者的SBP逐渐下降，而对照组无此现象。症状出现在100±7 mmHg时。试验结束时，患者的SBP显著低于对照组。患者TPR逐渐下降，而对照组无此现象。SV和CO无显著变化。患者的HR在试验结束前逐渐增加，而对照组保持不变。使用加压绷带积极治疗可避免SBP和TPR下降，而CO变化极小。
在延迟性OH患者中，SBP的逐渐下降与TPR的逐渐下降相关，而CO和SV变化很小；HR的代偿性增加不足以补偿血压下降。
