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高温环境下老年人心脏β1 反应性改变。

Altered cardiac β1 responsiveness in hyperthermic older adults.

机构信息

Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas and University of Texas Southwestern Medical Center, Dallas, Texas.

Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark.

出版信息

Am J Physiol Regul Integr Comp Physiol. 2022 Oct 1;323(4):R581-R588. doi: 10.1152/ajpregu.00040.2022. Epub 2022 Sep 12.

Abstract

Compared with younger adults, passive heating induced increases in cardiac output are attenuated by ∼50% in older adults. This attenuated response may be associated with older individuals' inability to maintain stroke volume through ionotropic mechanisms and/or through altered chronotropic mechanisms. The purpose of this study was to identify the interactive effect of age and hyperthermia on cardiac responsiveness to dobutamine-induced cardiac stimulation. Eleven young (26 ± 4 yr) and 8 older (68 ± 5 yr) participants underwent a normothermic and a hyperthermic (baseline core temperature +1.2°C) trial on the same day. In both thermal conditions, after baseline measurements, intravenous dobutamine was administered for 12 min at 5 µg/kg/min, followed by 12 min at 15 µg/kg/min. Primary measurements included echocardiography-based assessments of cardiac function, gastrointestinal and skin temperatures, heart rate, and mean arterial pressure. Heart rate responses to dobutamine were similar between groups in both thermal conditions ( > 0.05). The peak systolic mitral annular velocity (S'), i.e., an index of left ventricular longitudinal systolic function, was similar between groups for both thermal conditions at baseline. While normothermic, the increase in S' between groups was similar with dobutamine administration. However, while hyperthermic, the increase in S' was attenuated in the older participants with dobutamine ( < 0.001). Healthy, older individuals show attenuated inotropic, but maintained chronotropic responsiveness to dobutamine administration during hyperthermia. These data suggest that older individuals have a reduced capacity to increase cardiomyocyte contractility, estimated by changes in S', via β1-adrenergic mechanisms while hyperthermic.

摘要

与年轻人相比,老年人被动加热引起的心输出量增加减少了约 50%。这种反应减弱可能与老年人无法通过离子机制和/或通过改变变时机制来维持每搏量有关。本研究的目的是确定年龄和高热对多巴酚丁胺诱导的心脏刺激的心脏反应性的交互作用。11 名年轻(26±4 岁)和 8 名老年(68±5 岁)参与者在同一天进行了正常体温和高热(基础核心体温+1.2°C)试验。在两种热条件下,在基线测量后,静脉给予多巴酚丁胺 12 分钟,剂量为 5μg/kg/min,然后 12 分钟,剂量为 15μg/kg/min。主要测量包括基于超声心动图的心脏功能评估、胃肠道和皮肤温度、心率和平均动脉压。在两种热条件下,心率对多巴酚丁胺的反应在两组之间相似(>0.05)。在两种热条件下,基线时两组的收缩期二尖瓣环速度峰值(S')即左心室纵向收缩功能的指标相似。在正常体温时,随着多巴酚丁胺的给予,两组之间的 S'增加相似。然而,在高热时,多巴酚丁胺在老年参与者中的 S'增加减弱(<0.001)。健康的老年人在高热时对多巴酚丁胺的变力反应(通过 S'的变化估计)减弱,但变时反应保持不变。这些数据表明,在高热时,老年人通过β1-肾上腺素能机制增加心肌细胞收缩力的能力降低,估计通过 S'的变化。

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