Gullestad L, Simonsen S, Kjekshus J
Medisinsk avdeling B Rikshospitalet, Oslo.
Tidsskr Nor Laegeforen. 1995 Jan 10;115(1):38-42.
Physical performance is markedly reduced in patients with congestive heart failure, but the reason has not been precisely defined. It has been generally assumed that reduced exercise performance is related to ventricular systolic performance, or as more recently suggested, to impaired left ventricular diastolic function. However, there is no clear relationship between the indices of left ventricular performance and exercise capacity, and there is a dissociation between improvement in haemodynamic parameters and exercise performance. Recent studies suggest that peripheral changes may be major determinants of exercise performance. This may involve reduced blood flow to the exercising limbs because of impaired vasodilatory capacity or intrinsic changes in the skeletal muscle itself. In this review, these factors are considered, and the impact of different therapeutic strategies is discussed.
充血性心力衰竭患者的身体机能显著下降，但其原因尚未明确界定。人们普遍认为运动能力下降与心室收缩功能有关，或者如最近所提出的，与左心室舒张功能受损有关。然而，左心室功能指标与运动能力之间并无明确关系，血流动力学参数的改善与运动表现之间也存在脱节。最近的研究表明，外周变化可能是运动表现的主要决定因素。这可能涉及由于血管舒张能力受损或骨骼肌自身的内在变化导致运动肢体的血流量减少。在这篇综述中，将对这些因素进行探讨，并讨论不同治疗策略的影响。
