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唐氏综合征成人在次最大强度和最大强度运动时的血流动力学及心肺反应。

Hemodynamic and cardiorespiratory responses to submaximal and maximal exercise in adults with Down syndrome.

作者信息

Oviedo Guillermo R, Carbó-Carreté María, Guerra-Balic Myriam, Tamulevicius Nauris, Esquius Laura, Guàrdia-Olmos Joan, Javierre Casimiro

机构信息

Faculty of Psychology, Education and Sport Science Blanquerna, University Ramon Llull, Barcelona, Spain.

School of Health Science Blanquerna, University Ramon Llull, Barcelona, Spain.

出版信息

Front Physiol. 2022 Aug 19;13:905795. doi: 10.3389/fphys.2022.905795. eCollection 2022.

Abstract

The genetic disorder causing Down syndrome (DS) affects the cardiorespiratory and hemodynamic parameters. When exercising, sufficient blood flow is necessary for active muscles. Cardiac output (Q) must be proportional to the peripheral requirements. In case the stroke volume (SV) is lower, the heart rate (HR) will increase further in order to maintain an adequate blood flow in the active territories (HR compensatory response). People with DS have a lower HR response to maximal exercise. Nevertheless, the response of the hemodynamic and cardiorespiratory parameters during the submaximal phases of maximal exercise was not well studied. to evaluate cardiorespiratory and hemodynamic parameters 1) during submaximal and 2) maximal metabolic treadmill test in individuals with and without DS. fifteen adults with DS (age = 27.33 ± 4.98 years old; n = 12 males/3 females) and 15 adults without disabilities, matched by age and sex, participated in this cross-sectional study. Peak and submaximal cardiorespiratory and hemodynamic parameters were measured during a treadmill test. Linear mixed-effects models were used to analyse interactions between the variables. Post-hoc analyses were employed to assess within and between-group differences. The DS group showed lower peak values for ventilation (VE), respiratory exchange ratio (RER), tidal volume (V), ventilatory equivalent for O (VEqO), end-tidal partial pressure for O (PO), O uptake (VO) and CO production (all < 0 .050), Q, SV, systolic and diastolic blood pressure (SBP, DBP), and HR (all < 0 .050). There were group-by-time interactions (all < 0 .050) for all ventilatory submaximal values. Significant group and time differences were observed for VE; RER; respiratory rate (RR); VEqO; PO; VO and V (all < 0 .050). There were also group-by-time interactions (all < 0 .050) and group and time differences for SBP, mean arterial blood pressure (MAP) and HR (all < 0.010). During submaximal exercise, we verified a compensatory response of HR, and greater VE and VO in the individuals with DS. In addition, we were able to observe that the DS group had a reduced SBP and MAP response to submaximal exercise. On the other hand, we found that adults with DS have lower peak hemodynamic and cardiorespiratory values, and a lower cardiac reserve. Further research is warranted to investigate the effects of these results on the general health of adults with DS and the impact of long-term exercise programs on these parameters.

摘要

导致唐氏综合征(DS)的基因紊乱会影响心肺和血流动力学参数。运动时,活跃的肌肉需要足够的血流量。心输出量(Q)必须与外周需求成比例。如果每搏输出量(SV)较低,心率(HR)将进一步增加,以维持活跃区域充足的血流量(HR代偿反应)。唐氏综合征患者对最大运动的心率反应较低。然而,最大运动次最大阶段期间血流动力学和心肺参数的反应尚未得到充分研究。本研究旨在评估有和没有唐氏综合征的个体在1)次最大运动和2)最大代谢跑步机测试期间的心肺和血流动力学参数。15名唐氏综合征成年人(年龄 = 27.33 ± 4.98岁;n = 12名男性/3名女性)和15名年龄和性别匹配的无残疾成年人参与了这项横断面研究。在跑步机测试期间测量峰值和次最大心肺及血流动力学参数。使用线性混合效应模型分析变量之间的相互作用。采用事后分析评估组内和组间差异。唐氏综合征组的通气量(VE)、呼吸交换率(RER)、潮气量(V)、氧通气当量(VEqO)、呼气末氧分压(PO)、氧摄取量(VO)和二氧化碳产生量(均P < 0.050)、Q、SV、收缩压和舒张压(SBP、DBP)以及HR(均P < 0.050)的峰值较低。所有通气次最大数值均存在组×时间交互作用(均P < 0.050)。在VE、RER、呼吸频率(RR)、VEqO、PO、VO和V方面观察到显著的组和时间差异(均P < 0.050)。SBP、平均动脉压(MAP)和HR也存在组×时间交互作用(均P < 0.050)以及组和时间差异(均P < 0.010)。在次最大运动期间,我们证实了唐氏综合征个体的HR代偿反应以及更大的VE和VO。此外,我们能够观察到唐氏综合征组对次最大运动的SBP和MAP反应降低。另一方面,我们发现唐氏综合征成年人的血流动力学和心肺峰值数值较低,心脏储备也较低。有必要进一步研究这些结果对唐氏综合征成年人总体健康的影响以及长期运动计划对这些参数的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dec6/9437284/431d115808a9/fphys-13-905795-g001.jpg

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