二尖瓣球囊扩张术后的运动通气

Exercise ventilation after balloon dilatation of the mitral valve.

作者信息

Banning A P, Lewis N P, Elborn J S, Hall R J

机构信息

Department of Cardiology, University of Wales College of Medicine, Heath Park, Cardiff.

出版信息

Br Heart J. 1995 Oct;74(4):386-9. doi: 10.1136/hrt.74.4.386.

DOI:10.1136/hrt.74.4.386

PMID:7488452

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC484044/

Abstract

BACKGROUND

Exertional dyspnoea is a limiting symptom in many patients with mitral stenosis but its causes remain incompletely understood. Ventilation during exercise is abnormal in chronic heart failure of all causes and there is increased ventilatory cost of carbon dioxide production.

PATIENTS

23 patients with rheumatic mitral stenosis undergoing percutaneous balloon dilatation of the mitral valve were studied to investigate exercise ventilation.

METHODS

Treadmill exercise tests with respiratory gas analysis were performed before and 1 day, 7 days, and 10 weeks after balloon dilatation of the mitral valve. The relation between ventilation (VE) and production (VCO2) was analysed by linear regression.

RESULTS

The VE/VCO2 slope was linear in all patients and before balloon dilatation of the mitral valve it correlated inversely with peak minute oxygen consumption (VO2) (rs = -0.47, P < 0.05), exercise duration (rs = -0.66, P < 0.01), and mitral valve area (rs = -0.5, P < 0.05). The VE/VCO2 slope declined acutely after balloon dilatation of the mitral valve (n = 10) (mean (SD) 41 (4) v 36 (2.9), P < 0.05) and did not change again thereafter. At 10 weeks (n = 23) exercise duration (460 (230) v 630 (240) s, P < 0.01) and peak VO2 (12.7 (4.3) v 14.9 (4.8) ml/kg/min, P < 0.05) increased significantly.

CONCLUSIONS

Patients with rheumatic mitral stenosis have a similar increase in the VE/VCO2 slope to that of patients with heart failure from other causes. Successful balloon dilatation of the mitral valve is associated with an acute reduction in the exercise VE/VCO2 slope.

摘要

背景

劳力性呼吸困难是许多二尖瓣狭窄患者的限制症状，但其病因仍未完全明确。各种原因导致的慢性心力衰竭患者运动时的通气均异常，且二氧化碳产生的通气成本增加。

患者

对23例行经皮球囊二尖瓣扩张术的风湿性二尖瓣狭窄患者进行研究以调查运动通气情况。

方法

在二尖瓣球囊扩张术前、术后1天、7天和10周进行带呼吸气体分析的跑步机运动试验。通过线性回归分析通气（VE）与二氧化碳产生量（VCO2）之间的关系。

结果

所有患者的VE/VCO2斜率呈线性，在二尖瓣球囊扩张术前，其与峰值分钟耗氧量（VO2）呈负相关（rs = -0.47，P < 0.05）、与运动持续时间呈负相关（rs = -0.66，P < 0.01）、与二尖瓣面积呈负相关（rs = -0.5，P < 0.05）。二尖瓣球囊扩张术后（n = 10），VE/VCO2斜率急性下降（平均（标准差）41（4）对36（2.9），P < 0.05），此后未再改变。在10周时（n = 23），运动持续时间（460（230）对630（240）秒，P < 0.01）和峰值VO2（12.7（4.3）对14.9（4.8）毫升/千克/分钟，P < 0.05）显著增加。