de Oliveira S F, Ramires J A, Solimene M C, Ratti M, Lage S G, da Luz P L, Pileggi F
Instituto do Coração do Hospital das Clínicas, FMUSP.
Arq Bras Cardiol. 1993 Jun;60(6):395-8.
To verify the exercise-induced hemodynamic changes in moderate hypertensive patients.
Twenty nine patients were studied and they were submitted to cycloergometer supine exercise (50w and 100w) during cardiac catheterization. The hemodynamic variables were measured: cardiac index (CI), stroke volume (SV), systemic arterial resistance (SAR), pulmonary arterial resistance (PAR), wedge pressure (WP), right atrial pressure (RA), systolic arterial pressure (SP), diastolic arterial pressure (DP), mean arterial pressure (MP) and heart rate (HR). To evaluate the cardiac function, the patients were divided in two groups: GI with CI > 2.5 ml/min/m2 and GII CI < 2.5 ml/min/m2.
During exercise, patients from GI and GII were similar-according to MAP, RA, WP, and HR. On the other hand, GI and GII exhibited different (#) behavior regarding SV, PAR and SAR. During the three exercise conditions, rest (R), 50w and 100w it was observed: a) PAR-R = 50 = 100 (GI); b) MP, PAR, WP, SV, SAR-R #50 #100 (GI); c) HR, PAR and SAR-R #50 #100 (GII). There was no correlation between the cardiac function (CI, SV) and the circulatory adjustment (PAR and SAR) or the pressure curve (SP, DP, MP) and HR.
The results suggest that the cardiac function of GI patients depends, mainly, on the inotropism, while in GII patients it depends on the decrease of the afterload (PAR and SAR). Those changes may appear even in the late exercise stage (100w), with a bias to attain the GI levels. Those observations suggest functional changes in vasomotor tone of GII patients.
验证中度高血压患者运动诱发的血流动力学变化。
对29例患者进行研究,在心脏导管插入术期间让他们进行仰卧位蹬车运动(50瓦和100瓦)。测量血流动力学变量:心脏指数(CI)、每搏输出量(SV)、体循环动脉阻力(SAR)、肺动脉阻力(PAR)、楔压(WP)、右心房压(RA)、收缩压(SP)、舒张压(DP)、平均动脉压(MP)和心率(HR)。为评估心脏功能,将患者分为两组:CI>2.5 ml/分钟/平方米的GI组和CI<2.5 ml/分钟/平方米的GII组。
运动期间,GI组和GII组患者在平均动脉压、右心房压、楔压和心率方面相似。另一方面,GI组和GII组在每搏输出量、肺动脉阻力和体循环动脉阻力方面表现出不同(#)的行为。在三种运动状态下,即静息(R)、50瓦和100瓦时,观察到:a)PAR-R = 50 = 100(GI组);b)MP、PAR、WP、SV、SAR-R #50 #100(GI组);c)HR、PAR和SAR-R #50 #100(GII组)。心脏功能(CI、SV)与循环调节(PAR和SAR)或压力曲线(SP、DP、MP)与心率之间无相关性。
结果表明,GI组患者的心脏功能主要取决于心肌收缩力,而GII组患者的心脏功能则取决于后负荷(PAR和SAR)的降低。这些变化甚至可能出现在运动后期(100瓦),倾向于达到GI组的水平。这些观察结果提示GII组患者血管运动张力存在功能变化。