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下体正压对心力衰竭患者左心室射血持续时间的影响。

The Effect of Lower Body Positive Pressure on Left Ventricular Ejection Duration in Patients With Heart Failure.

作者信息

Avadhani Sriya, Ihsan Muhammad, Nunez Arismendy, Kamran Haroon, Singh Sahib, Hasan Zohair, Salciccioli Louis, Kral John G, Godwin Ellen M, Lazar Jason

机构信息

Division of Cardiovascular Medicine, State University of New York Downstate Medical Center, Brooklyn, NY, USA.

Departments of Surgery and Medicine, State University of New York Downstate Medical Center, Brooklyn, NY, USA.

出版信息

Dose Response. 2018 Nov 25;16(4):1559325818811543. doi: 10.1177/1559325818811543. eCollection 2018 Oct-Dec.

Abstract

Lower body positive pressure (LBPP) treadmill activity might benefit patients with heart failure (HF). To determine the short-term effects of LBPP on left ventricular (LV) function in HF patients, LV ejection duration (ED), a measure of systolic function was prospectively assessed in 30 men with stable HF with LV ejection fraction ≤ 40% and 50 healthy men (N). Baseline measurements (100% body weight), including blood pressure (BP), heart rate (HR) and LVED, obtained via radial artery applanation tonometry, were recorded after 2 minutes of standing on weight support treadmill and after LBPP achieving reductions of 25%, 50%, and 75% of body weight in random sequence. Baseline, HR, and LVED (251 ± 5 vs 264 ± 4 ms; = .035) were lower in the HF group. The LBPP lowered HR more (14% vs 6%, = .009) and increased LVED more (15% ± 7% vs 10% ± 6%; = .004) in N versus HF. Neither group had changes (Δ) in BP. On generalized linear regression, the 2 groups showed different responses ( < .001). Multivariate analysis showed %ΔHR ( < .001) and HF ( = .026) were predictive of ΔED ( = 0.44; < .001). In conclusion, progressive LBPP increases LVED in a step-wise manner in N and HF patients independent of HR lowering. The ΔLVED is less marked in patients with HF.

摘要

下半身正压(LBPP)跑步机运动可能对心力衰竭(HF)患者有益。为了确定LBPP对HF患者左心室(LV)功能的短期影响,对30名左心室射血分数≤40%的稳定HF男性患者和50名健康男性(N)进行了前瞻性评估,测量了收缩功能指标左心室射血持续时间(ED)。通过桡动脉压平式眼压测量法获得的基线测量值(100%体重),包括血压(BP)、心率(HR)和左心室舒张末期内径(LVED),在患者站在体重支持跑步机上2分钟后以及按随机顺序使LBPP达到体重减轻25%、50%和75%后进行记录。HF组的基线、HR和LVED(251±5 vs 264±4毫秒;P = 0.035)较低。与HF组相比,LBPP使N组的HR降低更多(14% vs 6%,P = 0.009),LVED增加更多(15%±7% vs 10%±6%;P = 0.004)。两组的BP均无变化(Δ)。在广义线性回归分析中,两组显示出不同的反应(P < 0.001)。多变量分析显示,%ΔHR(P < 0.001)和HF(P = 0.026)可预测ΔED(R² = 0.44;P < 0.001)。总之,在N组和HF组患者中,逐渐增加的LBPP以逐步方式增加LVED,且与HR降低无关。HF患者的ΔLVED不太明显。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59dd/6256315/76b8d9abe6cc/10.1177_1559325818811543-fig1.jpg

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