Zamani Payman, Proto Elizabeth A, Mazurek Jeremy A, Prenner Stuart B, Margulies Kenneth B, Townsend Raymond R, Kelly Daniel P, Arany Zoltan, Poole David C, Wagner Peter D, Chirinos Julio A
Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Division of Nephrology/Hypertension, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
JACC Basic Transl Sci. 2020 Mar 23;5(3):211-225. doi: 10.1016/j.jacbts.2020.01.003. eCollection 2020 Mar.
The aim of this study was to determine the arteriovenous oxygen content difference (ΔAVo) in adult subjects with and without heart failure with preserved ejection fraction (HFpEF) during systemic and forearm exercise. Subjects with HFpEF had reduced ΔAVo. Forearm diffusional conductance for oxygen, a lumped conductance parameter that incorporates all impediments to the movement of oxygen from red blood cells in skeletal muscle capillaries into the mitochondria within myocytes, was estimated. Forearm diffusional conductance for oxygen was not different among adults with HFpEF, those with hypertension, and healthy control subjects; therefore, diffusional conductance cannot explain the reduced forearm ΔAVo. Instead, adiposity was strongly associated with ΔAVo, suggesting an active role for adipose tissue in reducing exercise capacity in patients with HFpEF.
本研究的目的是确定射血分数保留的心力衰竭（HFpEF）成年患者和无HFpEF成年患者在全身运动和前臂运动期间的动静脉氧含量差（ΔAVo）。HFpEF患者的ΔAVo降低。估算了前臂氧扩散传导率，这是一个综合了氧气从骨骼肌毛细血管中的红细胞进入肌细胞内线粒体运动的所有阻碍因素的总传导参数。HFpEF成年患者、高血压成年患者和健康对照受试者之间的前臂氧扩散传导率无差异；因此，扩散传导率无法解释前臂ΔAVo降低的原因。相反，肥胖与ΔAVo密切相关，提示脂肪组织在降低HFpEF患者运动能力方面发挥了积极作用。
