Miyakoda H, Kitamura H, Kinugawa T, Saito M, Kotake H, Mashiba H
First Department of Internal Medicine, Tottori University School of Medicine, Yonago, Japan.
Jpn J Med. 1990 Sep-Oct;29(5):493-9. doi: 10.2169/internalmedicine1962.29.493.
To evaluate the cardiovascular and plasma catecholamine responses to dynamic exercise in patients with cardiac neurosis (CN), treadmill testing was performed. Thirty-four patients with CN were chosen for this study based on exercise tolerance and the results were compared with those in 31 patients with organic heart disease and 12 normal subjects. Patients with CN showed an augmentation of cardiovascular and plasma catecholamine responses. The augmentation of the norepinephrine response in patients with CN was not as remarkable as that in patients with organic heart disease. On the other hand, the augmentation of the epinephrine response was greater in patients with CN than in those with organic heart disease. Administration of metoprolol (40 mg/day) for two weeks improved exercise tolerance in patients with CN. We suggest that anxiety augments both sympatho-neural and sympatho-adrenal activity and that it is the symptoms induced by the augmented cardiovascular response which reduce exercise tolerance in patients with CN.
为评估心脏神经症（CN）患者对动态运动的心血管和血浆儿茶酚胺反应，进行了跑步机测试。基于运动耐量选择了34例CN患者进行本研究，并将结果与31例器质性心脏病患者和12名正常受试者的结果进行比较。CN患者表现出心血管和血浆儿茶酚胺反应增强。CN患者去甲肾上腺素反应的增强不如器质性心脏病患者显著。另一方面，CN患者肾上腺素反应的增强比器质性心脏病患者更大。给予美托洛尔（40mg/天）两周可改善CN患者的运动耐量。我们认为焦虑会增强交感神经和交感肾上腺活动，并且正是增强的心血管反应所诱发的症状降低了CN患者的运动耐量。
