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被动抬腿试验中血流动力学变化值对射血分数保留的心力衰竭患者运动能力的预测作用

Values of hemodynamic variation in response to passive leg raising in predicting exercise capacity of heart failure with preserved ejection fraction.

作者信息

Zhou Hong-Lian, Ding Ling, Mi Tao, Zheng Kai, Wu Xiao-Fen, Wang Jing, Liu Meng-Ying, Zhang Le, Zhang Cun-Tai, Quan Xiao-Qing

机构信息

Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Medicine (Baltimore). 2016 Nov;95(44):e5322. doi: 10.1097/MD.0000000000005322.

Abstract

In heart failure patients with preserved ejection fraction, their hemodynamic parameters usually change when they are from recumbent to passive leg raising. The authors designed this study to investigate the relationship between hemodynamic parameters measured by impedance cardiography (ICG) and 6-minute walk distance (6MWD) of heart failure with preserved ejection fraction (HFPEF). We recruited 49 subjects with HFPEF in the study, and all the subjects were separated into 2 groups: the patients whose hemodynamic parameters rose after passive leg raising were in group 1 (n = 26) and the patients whose hemodynamic parameters did not rise after passive leg raising were in group 2 (n = 23). Our study then compared the 6MWD, left ventricular ejection fraction, and plasma NT-pro-brain natriuretic peptide between the 2 groups. Group 1 had significantly longer 6MWD than group 2 (515.38 ± 24.97 vs 306.39 ± 20.20 m; P = 0.043). Hemodynamic parameters measured by ICG significantly correlated with 6MWD in both groups. Patients whose hemodynamic parameters rose in response to passive leg raising were more likely to have better exercise capacity. Hemodynamic variation in response to passive leg raising measured by ICG may be more sensitive in predicting exercise capacity of patients with HFPEF.

摘要

在射血分数保留的心力衰竭患者中,当他们从卧位变为被动抬腿时,其血流动力学参数通常会发生变化。作者设计了这项研究,以探讨通过阻抗心动图(ICG)测量的血流动力学参数与射血分数保留的心力衰竭(HFPEF)患者6分钟步行距离(6MWD)之间的关系。我们在研究中招募了49名HFPEF受试者,所有受试者被分为2组:被动抬腿后血流动力学参数升高的患者为第1组(n = 26),被动抬腿后血流动力学参数未升高的患者为第2组(n = 23)。然后我们的研究比较了两组之间的6MWD、左心室射血分数和血浆N末端脑钠肽前体。第1组的6MWD明显长于第2组(515.38±24.97 vs 306.39±20.20 m;P = 0.043)。两组中通过ICG测量的血流动力学参数均与6MWD显著相关。被动抬腿后血流动力学参数升高的患者更有可能具有更好的运动能力。通过ICG测量的被动抬腿引起的血流动力学变化在预测HFPEF患者的运动能力方面可能更敏感。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/56e5/5591162/27f4f5b883db/medi-95-e5322-g001.jpg

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