Department of Health Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil.
Respir Physiol Neurobiol. 2012 Mar 15;180(2-3):269-74. doi: 10.1016/j.resp.2011.12.002. Epub 2011 Dec 13.
Were evaluated individuals divided into two groups: we studied chronic heart failure (CHF) (19 patients with CHF plus cardiomegaly) and control (12 healthy volunteers) during performance of inspiratory loaded breathing (ILB). We evaluated: spirometry, functional capacity through the six-minute walk test (6MWT), and distribution of thoracoabdominal volumes via optoelectronic plethysmography (OEP), namely volume variations of pulmonary rib cage (Vrc,p), abdominal rib cage (Vrc,a), and abdomen (Vab). In each compartment, the percentage contributions of right and left sides were also calculated. During ILB, patients with heart failure were characterized by a significant reduction of the Vrc,a volume variations compared to the control group. Correlations were found between left %Vrc,a on the left side measured during ILB and left ventricular ejection fraction (r=0.468; p=0.049), and dyspnea after the 6MWT (r=-0.878; p<0.01).Then, patients with CHF and cardiomegaly are characterized by a reduced mobility in left part of the lower part of the rib cage, that contributes leading to increased perception of dyspnea during submaximal exercise.
一组为慢性心力衰竭(CHF)患者(19 例 CHF 合并心脏扩大),另一组为对照组(12 例健康志愿者),并在两组中进行吸气负荷呼吸(ILB)。我们评估了以下内容:肺量测定、六分钟步行试验(6MWT)的功能能力,以及光体积描记法(OEP)测量的胸腹部容积分布,即肺胸廓(Vrc,p)、腹部胸廓(Vrc,a)和腹部(Vab)的体积变化。在每个隔室中,还计算了右侧和左侧的百分比贡献。在 ILB 期间,心力衰竭患者的 Vrc,a 体积变化与对照组相比显著降低。在 ILB 期间测量的左侧左%Vrc,a 与左心室射血分数(r=0.468;p=0.049)和 6MWT 后呼吸困难(r=-0.878;p<0.01)之间存在相关性。然后,CHF 合并心脏扩大的患者左下部肋骨的移动性降低,导致在亚最大运动期间呼吸困难的感知增加。