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患有小腹部主动脉瘤的患者急性运动时的主动脉和系统性动脉僵硬反应。

Aortic and Systemic Arterial Stiffness Responses to Acute Exercise in Patients With Small Abdominal Aortic Aneurysms.

机构信息

VasoActive Research Group, School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, QLD, Australia.

VasoActive Research Group, School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, QLD, Australia; Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia.

出版信息

Eur J Vasc Endovasc Surg. 2019 Nov;58(5):708-718. doi: 10.1016/j.ejvs.2019.02.021. Epub 2019 Oct 17.

Abstract

OBJECTIVE/BACKGROUND: Elevated arterial stiffness is a characteristic of abdominal aortic aneurysm (AAA), and is associated with AAA growth and cardiovascular mortality. A bout of exercise transiently reduces aortic and systemic arterial stiffness in healthy adults. Whether the same response occurs in patients with AAA is unknown. The effect of moderate- and higher intensity exercise on arterial stiffness was assessed in patients with AAA and healthy adults.

METHODS

Twenty-two men with small diameter AAAs (36 ± 5 mm; mean age 74 ± 6 years) and 22 healthy adults (mean age 72 ± 5 years) were included. Aortic stiffness was measured using carotid to femoral pulse wave velocity (PWV), and systemic arterial stiffness was estimated from the wave reflection magnitude (RM) and augmentation index (Alx75). Measurements were performed at rest and during 90 min of recovery following three separate test sessions in a randomised order: (i) moderate intensity continuous exercise; (ii) higher intensity interval exercise; or (iii) seated rest.

RESULTS

At rest, PWV was higher in patients with AAA than in healthy adults (p < .001), while AIx75 and RM were similar between groups. No differences were observed between AAA patients and healthy adults in post-exercise aortic and systemic arterial stiffness after either exercise protocol. When assessed as the change from baseline (delta, Δ), post-exercise ΔAIx75 was not different to the seated rest protocol. Conversely, post-exercise ΔPWV and ΔRM were both lower at all time points than seated rest (p < .001). ΔPWV was lower immediately after higher intensity than after moderate intensity exercise (p = .015).

CONCLUSION

High resting aortic stiffness in patients with AAA is not exacerbated after exercise. There was a similar post-exercise attenuation in arterial stiffness between patients with AAA and healthy adults compared with seated rest. This effect was most pronounced following higher intensity interval exercise, suggesting that this form of exercise may be a safe and effective adjunctive therapy for patients with small AAAs.

摘要

目的/背景:动脉僵硬度升高是腹主动脉瘤(AAA)的特征,并与 AAA 生长和心血管死亡率相关。健康成年人进行一次运动可短暂降低主动脉和全身动脉僵硬度。尚不清楚这种反应是否会发生在 AAA 患者中。本研究评估了中等强度和更高强度运动对 AAA 患者和健康成年人动脉僵硬度的影响。

方法

共纳入 22 名 AAA 患者(AAA 直径小,36±5mm;平均年龄 74±6 岁)和 22 名健康成年人(平均年龄 72±5 岁)。采用颈股脉搏波速度(PWV)测量主动脉僵硬度,通过波反射幅度(RM)和增强指数(Alx75)估计全身动脉僵硬度。分别在 3 次随机序贯测试中(i)中等强度连续运动;(ii)更高强度间歇运动;或(iii)坐姿休息后,在休息和 90 分钟恢复期内进行测量。

结果

休息时,AAA 患者的 PWV 高于健康成年人(p<0.001),而 AIx75 和 RM 在两组之间无差异。在两种运动方案后,AAA 患者与健康成年人的运动后主动脉和全身动脉僵硬度均无差异。当作为从基线的变化(delta,Δ)评估时,运动后ΔAIx75 与坐姿休息方案无差异。相反,与坐姿休息相比,运动后所有时间点的ΔPWV 和ΔRM 均较低(p<0.001)。高强度运动后即刻的ΔPWV 低于中等强度运动后(p=0.015)。

结论

AAA 患者休息时的主动脉僵硬度较高,但运动后不会加重。与坐姿休息相比,AAA 患者和健康成年人的运动后动脉僵硬度均有类似的降低。与中等强度间歇运动相比,高强度间歇运动后这种作用更为明显,这表明这种运动形式可能是治疗小 AAA 患者的一种安全有效的辅助治疗方法。

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