Bendien C, Bossina K K, Buurma A E, Gerding A M, Kuipers J R, Landsman M L, Mook G A, Zijlstra W G
Circulation. 1984 Dec;70(6):929-34. doi: 10.1161/01.cir.70.6.929.
We studied the hemodynamic effects of dynamic exercise during cardiac catheterization in 35 children and adolescents with small-to-moderate ventricular septal defects. Eighteen of them exercised at 25% and 50% of their maximum workload and 17 exercised at 60%. There was no significant difference between the two groups with respect to age and body mass, height, and surface area. The changes evoked by exercise showed the same pattern at the different workloads, although they were more marked at the higher than at the lower percentage of maximum workload. During exercise the pulmonary vascular resistance did not change, in contrast to the systemic vascular resistance, which decreased. The pulmonary and systemic blood flows both increased, while the left-to-right shunt flow did not change, which led to a decrease of the left-to-right shunt fraction. As the heart rate increased and the shunt flow did not change, the shunt volume per beat decreased during exercise. We conclude that in patients with small-to-moderate ventricular septal defects the hemodynamic effects of dynamic exercise are favorable because the normal rise in systemic blood flow occurs without a corresponding increase in left-to-right shunt flow. Consequently, children and adolescents with such defects should not be restricted in their dynamic exercise activities.
我们研究了35例中小室间隔缺损儿童及青少年在心脏导管插入术期间进行动态运动的血流动力学效应。其中18例以其最大工作量的25%和50%进行运动，17例以60%进行运动。两组在年龄、体重、身高和体表面积方面无显著差异。运动引起的变化在不同工作量下呈现相同模式，尽管在最大工作量的较高百分比时比在较低百分比时更为明显。运动期间，与全身血管阻力降低相反，肺血管阻力未发生变化。肺血流量和体循环血流量均增加，而左向右分流流量未改变，这导致左向右分流分数降低。由于心率增加而分流流量未改变，运动期间每搏分流量减少。我们得出结论，对于中小室间隔缺损患者，动态运动的血流动力学效应是有利的，因为体循环血流量正常增加，而左向右分流流量没有相应增加。因此，患有此类缺损的儿童和青少年不应限制其动态运动活动。
