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心肌梗死后患者的呼吸肌耐力受到通气效率降低的限制。

Respiratory muscle endurance is limited by lower ventilatory efficiency in post-myocardial infarction patients.

机构信息

Cardiovascular Physical Therapy Laboratory, Nucleus of Research in Physical Exercise, Universidade Federal de Sao Carlos, Sao Carlos, SP, Brazil.

出版信息

Braz J Phys Ther. 2014 Jan-Feb;18(1):1-8. doi: 10.1590/s1413-35552012005000134. Epub 2014 Feb 1.

DOI:10.1590/s1413-35552012005000134
PMID:24675907
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4183236/
Abstract

BACKGROUND

Reduced respiratory muscle endurance (RME) contributes to increased dyspnea upon exertion in patients with cardiovascular disease.

OBJECTIVE

The objective was to characterize ventilatory and metabolic responses during RME tests in post-myocardial infarction patients without respiratory muscle weakness.

METHOD

Twenty-nine subjects were allocated into three groups: recent myocardial infarction group (RG, n=9), less-recent myocardial infarction group (LRG, n=10), and control group (CG, n=10). They underwent two RME tests (incremental and constant pressure) with ventilatory and metabolic analyses. One-way ANOVA and repeated measures one-way ANOVA, both with Tukey post-hoc, were used between groups and within subjects, respectively.

RESULTS

Patients from the RG and LRG presented lower metabolic equivalent and ventilatory efficiency than the CG on the second (50± 06, 50± 5 vs. 42± 4) and third part (50± 11, 51± 10 vs. 43± 3) of the constant pressure RME test and lower metabolic equivalent during the incremental pressure RME test. Additionally, at the peak of the incremental RME test, RG patients had lower oxygen uptake than the CG.

CONCLUSIONS

Post-myocardial infarction patients present lower ventilatory efficiency during respiratory muscle endurance tests, which appears to explain their inferior performance in these tests even in the presence of lower pressure overload and lower metabolic equivalent.

摘要

背景

呼吸肌耐力降低(RME)可导致心血管疾病患者在运动时呼吸困难加重。

目的

本研究旨在描述无呼吸肌无力的心肌梗死后患者在 RME 试验中呼吸和代谢的反应。

方法

29 名受试者被分为三组:近期心肌梗死组(RG,n=9)、非近期心肌梗死组(LRG,n=10)和对照组(CG,n=10)。他们进行了两次 RME 试验(递增和恒压),并进行了通气和代谢分析。分别采用单因素方差分析和重复测量的单因素方差分析,以及 Tukey 事后检验,比较组间和组内差异。

结果

在恒压 RME 试验的第二部分(50±06、50±5 与 42±4)和第三部分(50±11、51±10 与 43±3),以及递增压力 RME 试验中,RG 和 LRG 组患者的代谢当量和通气效率均低于 CG 组。此外,在递增 RME 试验的峰值时,RG 患者的摄氧量低于 CG 组。

结论

心肌梗死后患者在呼吸肌耐力试验中表现出较低的通气效率,这似乎可以解释即使在较低的压力负荷和较低的代谢当量下,他们在这些试验中的表现较差。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d6c/4183236/b1c994686044/rbfis-18-01-0001-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d6c/4183236/7fdb9949d616/rbfis-18-01-0001-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d6c/4183236/b1c994686044/rbfis-18-01-0001-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d6c/4183236/7fdb9949d616/rbfis-18-01-0001-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d6c/4183236/b1c994686044/rbfis-18-01-0001-g02.jpg

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