Norepinephrine alters exercise oxygen consumption in heart failure patients.
Norepinephrine alters exercise oxygen consumption in heart failure patients.
复制标题
去甲肾上腺素改变心力衰竭患者的运动耗氧量。
DOI：
10.1097/00005768-200012000-00010
复制
发表时间：
2000
影响因子：
4.1
通讯作者：
Levy,WC
中科院分区：
文献类型：
--
作者：
Leclerc,KM;Steele,NP;Levy,WC
目的探讨急性去甲肾上腺素（NE）静脉输注对心力衰竭患者运动氧利用率的影响，并与健康成人进行比较（射血分数< 40%）未接受β-受体阻滞剂治疗的患者在安慰剂或NE输注条件下进行稳态运动，随后进行最大斜坡运动测试。氧利用率，血流动力学反应，和血清乳酸NE水平进行了evaluated.ResultsThe NE的血流动力学效应是明显的，在这两个组的血压和伴随的心率下降具有统计学意义的增加。在所有条件下心力衰竭受试者的乳酸水平较高，稳态运动使水平增加24%（P= 0.04）。NE输注使乳酸水平增加24%（P= 0.19）。NE输注倾向于增加CHF受试者稳态运动结束时的耗氧量（VO 2）（4%变化; P= 0.06）。与健康成人相比，NE输注显著损害（增加）心力衰竭受试者的总VO 2/W关系（P= 0.037）。CHF受试者中NE输注后净效率也有适度恶化（降低）趋势。有没有显着的不良反应，低剂量NE输液在任一group.ConclusionsWe得出结论，1）急性低剂量NE输液损害氧利用率在稳定的心力衰竭患者，但在健康成人。这可能有助于解释伴随充血性心力衰竭的运动不耐受。2)在健康成人和代偿性心力衰竭患者中，急性输注低剂量NE是安全的，耐受性良好。
PurposeThe primary aim of this research was to evaluate the effect of acute norepinephrine (NE) infusion on the exercise oxygen utilization in heart failure patients as compared with healthy adults.MethodsEleven healthy adults and 10 patients with NYHA class II-III heart failure (ejection fraction< 40%) who were not on beta-blocker therapy underwent steady state exercise under placebo or NE infusion conditions, followed by maximal ramp exercise testing. Oxygen utilization, hemodynamic responses, and serum lactate NE levels were evaluated.ResultsThe hemodynamic effects of NE were evident in both groups with statistically significant increases in blood pressure and concomitant decreases in heart rates. Lactate levels were higher in heart failure subjects under all conditions and steady state exercise increased levels by 24%(P= 0.04). NE infusion increased lactate levels by a nonsignificant 24%(P= 0.19). NE infusion tended to increase oxygen consumption (VO2) at the end of steady state exercise in CHF subjects (4% change; P= 0.06). Compared with healthy adults, NE infusion significantly impaired (increased) the gross VO2/W relationship in heart failure subjects (P= 0.037). There was also a modest trend for a worsening (decrease) in net efficiency after NE infusion in CHF subjects. There were no significant adverse effects of low-dose NE infusion in either group.ConclusionsWe conclude that 1) acute low-dose NE infusion impairs the oxygen utilization in stable heart failure patients but not in healthy adults. This may help to explain the exercise intolerance that accompanies congestive heart failure. 2) Acute infusion of low-dose NE infusion is safe and well tolerated in both healthy adults and compensated heart failure patients.