Breathing strategy to preserve exercising cardiac function in patients with heart failure.
Breathing strategy to preserve exercising cardiac function in patients with heart failure.
复制标题
DOI：
10.1016/j.mehy.2009.09.030
复制
发表时间：
2010-03
影响因子：
4.7
通讯作者：
Johnson, B. D.
中科院分区：
文献类型：
--
作者：
Lalande, S.;Johnson, B. D.
心脏和肺紧密相连，因为它们串联在一起，共享共同的表面积并在胸腔内竞争空间。心脏和肺暴露于胸内压的类似变化，并且一个器官内的反射可以影响另一个器官（即，肺膨胀对心率的迷走神经影响）。在心力衰竭患者中，由于肺和左心室顺应性降低、心脏大小增加、心脏充盈压升高和受体对神经激活的敏感性改变，这些心肺相互作用可能发生改变。运动通过刺激呼吸深度和频率的增加（这加剧了胸内压的波动）以及通过要求心搏量和心率的大幅增加以响应增加的代谢需求，进一步影响心肺相互作用。我们实验室以前的工作表明，心力衰竭患者在运动期间避免高肺容量，这通常是以不必要的大呼气胸内压为代价的，从而导致显著的精力浪费。此外，我们还观察到，心力衰竭患者肺容量的自愿增加会引起轻度相对心动过缓，这在年龄相似的健康个体中未观察到。因此，我们假设，心力衰竭患者在运动中经常采用的快速浅低肺容量呼吸结合呼气正压胸内压是一种尝试，以保持甚至增强心脏对运动的反应。
The heart and lungs are closely linked as they lie in series, share a common surface area and compete for space within the thoracic cavity. The heart and lungs are exposed to the similar changes in intrathoracic pressure, and reflexes within one organ can influence the other (i.e. vagal influence of lung inflation on heart rate). In patients with heart failure, these cardiopulmonary interactions may be altered due to decreased lung and left ventricular compliance, increased cardiac size, high cardiac filling pressure and altered receptor sensitivity to neural activation. Exercise further affects the cardiopulmonary interactions by stimulating an increase in the depth and frequency of breathing which accentuates the fluctuations in intrathoracic pressure, and by requiring large increases in stroke volume and heart rate in order to respond to the increased metabolic demand. Previous work from our laboratory suggested that patients with heart failure avoid high lung volumes during exercise, often at the expense of unnecessary large positive expiratory intrathoracic pressures resulting in significant wasted effort. Moreover, we also observed that voluntarily increases in lung volume in patients with heart failure induced a mild relative bradycardia, a response not observed in similar aged healthy individuals. Thus, we hypothesized that the rapid shallow low lung volume breathing, in combination with positive expiratory intrathoracic pressure, often adopted by patients with heart failure during exercise is an attempt to preserve, or even enhance, the cardiac response to exercise.
登录
查看更多内容
影响因子：
5.9
作者：
HOSENPUD, JD;STIBOLT, TA;SHELLEY, D
通讯作者：
SHELLEY, D
影响因子：
37.8
作者：
BRENNER, JI;WAUGH, RA
通讯作者：
WAUGH, RA
DOI：
10.3109/00365516909080171
发表时间：
1969-01-01
影响因子：
2.1
作者：
BUGGEASPERHEIM, B;KIIL, F
通讯作者：
KIIL, F
影响因子：
3.3
作者：
COAST, JR;THOMPSON, GS;CASSIDY, SS
通讯作者：
CASSIDY, SS
影响因子：
37.8
作者：
BRINKER, JA;WEISS, JL;WEISFELDT, ML
通讯作者：
WEISFELDT, ML