Blake J W, Solangi K B, Herman M V, Goodman A A, Meggs L G
Division of Cardiology, New York Medical College, Valhalla.
Arch Intern Med. 1989 Feb;149(2):433-6.
Left ventricular (LV) function during rest and during exercise was evaluated in patients with end-stage renal disease (ESRD) in whom other causes of LV dysfunction were eliminated through rigid selection criteria. Autonomic function was also assessed in these patients with Valsalva's maneuver and plasma catecholamine determinations. Echocardiography and radionuclide ventriculography in the group with ESRD revealed no abnormalities of LV wall motion or ejection fraction. During graded exercise, patients with ESRD achieved 85% of age-predicted heart rate, and no differences in exercise tolerance or LV function were observed. Valsalva's response was abnormal in patients with ESRD, and post exercise the norepinephrine level was markedly increased (12.5 +/- 1.43 vs 8.28 +/- 0.82 nmol/L). Our results fail to indicate an independent adverse effect of ESRD on LV function.
通过严格的选择标准排除了其他导致左心室功能障碍的病因后，对终末期肾病（ESRD）患者静息和运动时的左心室（LV）功能进行了评估。还通过瓦尔萨尔瓦动作和血浆儿茶酚胺测定对这些患者的自主神经功能进行了评估。ESRD组的超声心动图和放射性核素心室造影显示左心室壁运动或射血分数无异常。在分级运动期间，ESRD患者达到了年龄预测心率的85%，且未观察到运动耐量或左心室功能的差异。ESRD患者的瓦尔萨尔瓦反应异常，运动后去甲肾上腺素水平显著升高（12.5±1.43对8.28±0.82 nmol/L）。我们的结果未能表明ESRD对左心室功能有独立的不利影响。
