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心力衰竭保留射血分数患者运动时的呼吸症状感知。

Respiratory symptom perception during exercise in patients with heart failure with preserved ejection fraction.

机构信息

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.

出版信息

Respir Physiol Neurobiol. 2024 Jul;325:104256. doi: 10.1016/j.resp.2024.104256. Epub 2024 Apr 6.


DOI:10.1016/j.resp.2024.104256
PMID:38583744
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11088520/
Abstract

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.

摘要

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。

相似文献

[1]
Respiratory symptom perception during exercise in patients with heart failure with preserved ejection fraction.

Respir Physiol Neurobiol. 2024-7

[2]
Respiratory symptom perception differs in obese women with strong or mild breathlessness during constant-load exercise.

Chest. 2014-2

[3]
Dyspnea on exertion provokes unpleasantness and negative emotions in women with obesity.

Respir Physiol Neurobiol. 2019-2

[4]
Weight loss reduces dyspnea on exertion and unpleasantness of dyspnea in obese men.

Respir Physiol Neurobiol. 2019-3

[5]
Impaired oxygen uptake kinetics in heart failure with preserved ejection fraction.

Heart. 2019-6-17

[6]
Clinical phenogroup diversity and multiplicity: Impact on mechanisms of exercise intolerance in heart failure with preserved ejection fraction.

Eur J Heart Fail. 2024-3

[7]
Identifying the Mechanisms of a Peripherally Limited Exercise Phenotype in Patients With Heart Failure With Preserved Ejection Fraction.

Circ Heart Fail. 2024-8

[8]
Mechanisms of exercise intolerance in heart failure with preserved ejection fraction: the role of abnormal peripheral oxygen extraction.

Circ Heart Fail. 2015-3

[9]
Cardiac output response to exercise in relation to metabolic demand in heart failure with preserved ejection fraction.

Eur J Heart Fail. 2013-2-20

[10]
Physiological dead space and arterial carbon dioxide contributions to exercise ventilatory inefficiency in patients with reduced or preserved ejection fraction heart failure.

Eur J Heart Fail. 2017-10-8

本文引用的文献

[1]
Ventilatory limitations in patients with HFpEF and obesity.

Respir Physiol Neurobiol. 2023-12

[2]
Normative Reference Equations for Breathlessness Intensity during Incremental Cardiopulmonary Cycle Exercise Testing.

Ann Am Thorac Soc. 2024-1

[3]
Elevated risk of dyspnea in adults with obesity.

Respir Physiol Neurobiol. 2023-12

[4]
Reducing Pulmonary Capillary Wedge Pressure During Exercise Exacerbates Exertional Dyspnea in Patients With Heart Failure With Preserved Ejection Fraction: Implications for V˙/Q˙ Mismatch.

Chest. 2023-9

[5]
Defining the Phenotypes for Heart Failure With Preserved Ejection Fraction.

Curr Heart Fail Rep. 2022-12

[6]
Alveolar Dead Space Is Augmented During Exercise in Patients With Heart Failure With Preserved Ejection Fraction.

Chest. 2022-12

[7]
Excess ventilation and exertional dyspnoea in heart failure and pulmonary hypertension.

Eur Respir J. 2022-11

[8]
The impact of obesity on the regulation of muscle blood flow during exercise in patients with heart failure with a preserved ejection fraction.

J Appl Physiol (1985). 2022-5-1

[9]
Physiological dead space during exercise in patients with heart failure with preserved ejection fraction.

J Appl Physiol (1985). 2022-3-1

[10]
Estimating exercise Pa in patients with heart failure with preserved ejection fraction.

J Appl Physiol (1985). 2022-1-1

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