Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA; Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Department of Psychology, Southern Methodist University, Dallas, TX, USA.
Respir Physiol Neurobiol. 2024 Jul;325:104256. doi: 10.1016/j.resp.2024.104256. Epub 2024 Apr 6.
We investigated whether central or peripheral limitations to oxygen uptake elicit different respiratory sensations and whether dyspnea on exertion (DOE) provokes unpleasantness and negative emotions in patients with heart failure with preserved ejection fraction (HFpEF). 48 patients were categorized based on their cardiac output (Q̇c)/oxygen uptake (V̇O) slope and stroke volume (SV) reserve during an incremental cycling test. 15 were classified as centrally limited and 33 were classified as peripherally limited. Ratings of perceived breathlessness (RPB) and unpleasantness (RPU) were assessed (Borg 0-10 scale) during a 20 W cycling test. 15 respiratory sensations statements (1-10 scale) and 5 negative emotions statements (1-10) were subsequently rated. RPB (Central: 3.5±2.0 vs. Peripheral: 3.4±2.0, p=0.86), respiratory sensations, or negative emotions were not different between groups (p>0.05). RPB correlated (p<0.05) with RPU (r=0.925), "anxious" (r=0.610), and "afraid" (r=0.383). While DOE provokes elevated levels of negative emotions, DOE and respiratory sensations seem more related to a common mechanism rather than central and/or peripheral limitations in HFpEF.
我们研究了摄氧量的中枢或外周限制是否会引起不同的呼吸感觉,以及运动性呼吸困难(DOE)是否会在射血分数保留的心力衰竭(HFpEF)患者中引起不适和负面情绪。根据递增循环测试中的心输出量(Q̇c)/摄氧量(V̇O)斜率和每搏量(SV)储备,48 名患者被分为中央受限和外周受限。在 20W 自行车测试中评估了感知呼吸急促(RPB)和不适(RPU)的评分(Borg 0-10 量表)。随后对 15 个呼吸感觉陈述(1-10 量表)和 5 个负面情绪陈述(1-10)进行了评分。两组间 RPB(中央:3.5±2.0 vs. 外周:3.4±2.0,p=0.86)、呼吸感觉或负面情绪无差异(p>0.05)。RPB 与 RPU(r=0.925)、“焦虑”(r=0.610)和“害怕”(r=0.383)相关(p<0.05)。虽然 DOE 会引起负面情绪升高,但 DOE 和呼吸感觉似乎与 HFpEF 中的中枢和/或外周限制更相关,而不是与中枢和/或外周限制有关。
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