Ikeda J, Haneda T, Kanda H, Shirato K, Koiwa Y, Kanazawa M, Ishikawa K, Ohe M, Hashiguchi R, Munakata K
Am Heart J. 1987 May;113(5):1103-7. doi: 10.1016/0002-8703(87)90919-7.
Although sympathetic excitation during mild exercise may readily occur in patients with mitral stenosis (MS), the degree of increment in plasma catecholamines has not been fully investigated. We imposed mild ergometric exercise (50 watts, 300 kg/min for 5 minutes) on five patients with mild MS (mitral valve area greater than or equal to 1.0 cm2) and eight with severe MS (mitral valve area less than 1.0 cm2) while they were undergoing cardiac catheterization. In patients with severe MS, total plasma catecholamine levels during exercise were remarkably higher (2821 +/- 783 [SEM] pg/ml) than in those with mild MS (957 +/- 113 pg/ml, p less than 0.05) and in seven control subjects (612 +/- 75 pg/ml, p less than 0.05). This marked increment could not be predicted by heart rate response, which did not differ between severe and mild MS (166 +/- 5 vs 153 +/- 10 bpm). In contrast with catecholamine change, the cardiac index in severe MS showed a very small increment. Results suggest that mild daily exercise can remarkably increase plasma catecholamine levels in severe MS, and this may accelerate various complications of this disorder.
尽管轻度运动期间的交感神经兴奋在二尖瓣狭窄（MS）患者中可能很容易出现，但血浆儿茶酚胺的增加程度尚未得到充分研究。我们在五名轻度MS患者（二尖瓣面积大于或等于1.0 cm²）和八名重度MS患者（二尖瓣面积小于1.0 cm²）进行心导管检查时，让他们进行轻度测力运动（50瓦，300 kg/分钟，持续5分钟）。在重度MS患者中，运动期间的血浆儿茶酚胺总水平（2821±783 [SEM] pg/ml）显著高于轻度MS患者（957±113 pg/ml，p<0.05）和七名对照受试者（612±75 pg/ml，p<0.05）。这种显著增加无法通过心率反应来预测，重度和轻度MS患者的心率反应并无差异（分别为166±5和153±10次/分钟）。与儿茶酚胺变化相反，重度MS患者的心脏指数仅显示出非常小的增加。结果表明，日常轻度运动可显著提高重度MS患者的血浆儿茶酚胺水平，这可能会加速该疾病的各种并发症。
