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心脏移植对慢性心力衰竭患者外周和呼吸肌质量及力量恢复的影响

Impact of Heart Transplantation on the Recovery of Peripheral and Respiratory Muscle Mass and Strength in Patients With Chronic Heart Failure.

作者信息

Fernandes Lenise C B C, de Oliveira Italo M, Fernandes Paula Frassinetti C B C, de Souza Neto João David, Farias Maria do Socorro Q, de Freitas Nilce A, Magalhães Nasser C, Bacal Fernando

机构信息

Heart Institute University of São Paulo School of Medicine and Heart and Lung Messejana's Hospital, Fortaleza, CE, Brazil.

Heart and Lung Messejana's Hospital, Fortaleza, CE, Brazil.

出版信息

Transplant Direct. 2018 Oct 1;4(11):e395. doi: 10.1097/TXD.0000000000000837. eCollection 2018 Nov.

Abstract

BACKGROUND

To assess the impact of heart transplantation (HT) on the recovery of peripheral and respiratory muscle mass and strength in patients with congestive heart failure.

METHODS

The study included 23 patients with an indication for HT (patients in the waiting list [WL] group). These patients were monitored for 1.5 to 3 years after HT; 8 died before 6 months of follow-up, 15 patients completed the early follow-up period of 6 months after HT (FU6m group), 4 died between 6 months and 3 years after HT, and 11 patients completed the late follow-up period 1.5 to 3 years after HT (FU1.5-3y group). Twenty-three healthy subjects were included in the control group. The study variables included inspiratory muscle strength, expressed as the maximum inspiratory pressure (MIP); expiratory muscle strength, expressed as the maximum expiratory pressure (MEP); peripheral muscle strength, expressed as bilateral handgrip strength (bHGS); and the cross-sectional area of the bilateral psoas major muscle (CSAbPm).

RESULTS

The results showed a reduction in the CSAbPm (1238.9 ± 312.3 mm), a reduction in the bHGS (27.0 ± 5.7 kg/f), a reduction in the MIP (60.2 ± 29.8 cmHO), and a reduction in the MEP (75.2 ± 33.4 cmHO) in patients in the WL group compared with the healthy controls. In the time series comparison, for patients in the WL, FU6m, and FU1.5-3y groups, increases were found in the CSAbPm (1305.4 vs 1458.1 vs 1431.3 mm, respectively), bHGS (27.3 vs 30.2 vs 34.7 kg/f, respectively), MIP (59.5 vs 85.5 vs 90.9 cmHO, respectively), and MEP (79.5 vs 93.2 vs 101.8 cmHO, respectively) ( < 0.00).

CONCLUSIONS

Sarcopenia was observed in patients in the WL group. Patients recovered peripheral and respiratory muscle mass and strength at 3 years after HT.

摘要

背景

评估心脏移植(HT)对充血性心力衰竭患者外周和呼吸肌质量及力量恢复的影响。

方法

该研究纳入了23例有心脏移植指征的患者(等待名单[WL]组)。这些患者在心脏移植后接受了1.5至3年的监测;8例在随访6个月前死亡,15例患者完成了心脏移植后6个月的早期随访期(FU6m组),4例在心脏移植后6个月至3年之间死亡,11例患者完成了心脏移植后1.5至3年的晚期随访期(FU1.5 - 3y组)。对照组纳入了23名健康受试者。研究变量包括吸气肌力量,以最大吸气压(MIP)表示;呼气肌力量,以最大呼气压(MEP)表示;外周肌力量,以双侧握力(bHGS)表示;以及双侧腰大肌的横截面积(CSAbPm)。

结果

结果显示,与健康对照组相比,WL组患者的CSAbPm(1238.9 ± 312.3 mm)、bHGS(27.0 ± 5.7 kg/f)、MIP(60.2 ± 29.8 cmH₂O)和MEP(75.2 ± 33.4 cmH₂O)均降低。在时间序列比较中,对于WL组、FU6m组和FU1.5 - 3y组的患者,CSAbPm(分别为1305.4 vs 1458.1 vs 1431.3 mm)、bHGS(分别为27.3 vs 30.2 vs 34.7 kg/f)、MIP(分别为59.5 vs 85.5 vs 90.9 cmH₂O)和MEP(分别为79.5 vs 93.2 vs 101.8 cmH₂O)均有所增加(P < 0.00)。

结论

WL组患者存在肌肉减少症。患者在心脏移植后3年恢复了外周和呼吸肌质量及力量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5e3/6233658/52a54203642d/txd-4-e395-g001.jpg

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