Physical Exercise Improves the Peripheral Microcirculation of Patients With Chronic Heart Failure
Physical Exercise Improves the Peripheral Microcirculation of Patients With Chronic Heart Failure
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DOI：
10.1097/hcr.0b013e3181b4ca4e
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发表时间：
2009-11-01
影响因子：
3.8
通讯作者：
Nanas, Serafim
中科院分区：
文献类型：
--
作者：
Gerovasili, Vasiliki;Drakos, Stavros;Nanas, Serafim
目的：慢性心力衰竭（CHF）患者存在微循环改变，部分归因于内皮功能障碍。运动训练已被证明对心力衰竭患者有益。本研究的目的是通过近红外光谱（NIRS）评估体育锻炼或CHF患者微循环的影响。方法：16例连续稳定的CHF患者（男性，n = 10；平均年龄= 50 = 12岁）参加了为期3个月的康复计划（每周3次）。在项目完成前后，所有患者都在循环计力器上进行了症状限制、斜坡式增量心肺运动测试。测量包括摄氧量峰值（VO2峰值）、厌氧阈值VO2 （at）和恢复第一分钟VO2的一级斜率（VO2/t斜率）。在康复计划前后，用气动袖带（闭塞技术）进行3分钟血管闭塞期间，用NI S连续测量大鱼际肌的组织氧饱和度。结果：血管闭塞解除后的氧再灌注率（%/min）和血管反应性（从27 +/- 13%/min增加到39 +/- 21% /min， P = 0.004）均显著提高。此外，VO2峰值和AT（由14.3 +/- 4.7 mL.kg）显著增加。min（-1）至16.7±6.3 mL.kg（-1）。min（-1）和9.5±3.6 mL.kg。min（-1）至11.3±4 mL.kg（-1）。min(-1), P =. 007和P =.012)以及VO2/t斜率（从0.35 +/- 0.17到0.51 +/- 0.07 mL.kg(-1)）。min(-1), P = 0.005)。结论：近红外光谱测量的CHF患者外周微循环在康复计划后得到改善。近红外光谱（NIRS）是一种无创技术，可用于评估康复对CHF患者外周微循环的影响。
PURPOSE: Patients with chronic heart failure (CHF) present with microcirculation alterations, partially attributed to endothelial dysfunction. Exercise training has been shown to induce beneficial effects in CHF patients. The aim Of Our Study was to assess the effect of physical exercise or the microcirculation of CHF patients by near-infrared spectroscopy (NIRS).METHODS: Sixteen consecutive stable CHF patients (men, n = 10; mean age = 50 = 12 years) participated in a 3-month rehabilitation program (3 sessions per week). All patients performed symptom-limited, ramp-incremental cardiopulmonary exercise testing on a cycle ergometer before and after the completion of the program. Measurements included peak oxygen uptake (VO2 peak), VO2 at anaerobic threshold (AT), and first-degree slope of VO2 during the first minute of recovery (VO2/t slope). Tissue oxygen saturation was continuously measured by NI S at the thenar muscle during a 3-minute vascular occlusion with a pneumatic cuff (occlusion technique) before and after the rehabilitation program.RESULTS: The oxygen reperfusion rate (%/min) following the release of vascular occlusion increased significantly after the rehabilitation program (450 +/- 105 to 532 +/- 151, P =.004) as did vascular reactivity (from 27 +/- 13%/min to 39 +/- 21 %/min, P = .006). In addition, there was a significant increase in VO2 peak and AT (from 14.3 +/- 4.7 mL.kg.min(-1) to 16.7 +/- 6.3 mL.kg(-1).min(-1) and from 9.5 +/- 3.6 mL.kg.min(-1) to 11.3 +/- 4 mL.kg(-1).min(-1), P = .007 and P =.012, respectively) as well as in VO2/t slope (from 0.35 +/- 0.17 to 0.51 +/- 0.07 mL.kg(-1).min(-1), P =.005).CONCLUSIONS: Peripheral microcirculation of CHF patients measured by NIRS improved after the rehabilitation program. NIRS is a noninvasive technique that could be used to evaluate the effect of rehabilitation on the peripheral microcirculation of CHF patients.