Cardiopulmonary interaction in heart failure
Cardiopulmonary interaction in heart failure
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DOI：
10.1016/j.pupt.2006.03.001
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发表时间：
2007-01-01
影响因子：
3.2
通讯作者：
Apostolo, Anna
中科院分区：
文献类型：
--
作者：
Agostoni, Piergiuseppe;Cattadori, Gala;Apostolo, Anna
在心力衰竭中，肺功能障碍是常见的，并且随着心力衰竭严重程度的加重而加重。它可以从肺力学和气体扩散的角度进行评估。的确，心肺相互作用与心脏大小和肺液含量有关；此外，心肺相互作用还受到身体位置的影响。慢性心力衰竭患者的肺弥散也会发生改变，气体弥散不足与运动能力下降有关。在运动过程中，心肺相互作用变得更加明显。心力衰竭患者由于呼吸频率逐渐增加和潮气量降低而表现出异常的过度换气；过度换气是由不同的原因引起的，包括化学和代谢受体的反应增强，CO(2)产生增加和死腔通气量增加。有几种药物会影响心力衰竭患者的呼吸模式：血管紧张素转换酶抑制剂和抗醛固酮药物可以改善运动时的肺扩散和通风效率；β-受体阻滞剂可以减少运动诱导的过度换气。此外，超滤通过减少体液含量来改善静息和运动时的肺活量。(C)2006爱思唯尔有限公司。保留所有权利。
In heart failure lung dysfunction is frequent and is greater the greater the heart failure severity. It can be evaluated in terms of lung mechanics and gas diffusion. Indeed heart-lung interaction is related to heart dimensions and lung fluid content; furthermore heart-lung interaction is influenced by the body position. Lung diffusion is also altered in patients with chronic heart failure, and a low gas diffusion is associated with a reduced performance. During exercise, heart-lung interaction becomes more evident. Heart failure patients show an abnormal hyperventilation due to a progressively increased respiratory rate, and a lower tidal volume; hyperventilation is due to different causes including enhanced responses from chemo- and metabolo-receptors, increased CO(2) production and increased dead space ventilation. Several drugs affect the ventilatory pattern in heart failure patients: ACE-inhibitors and anti-aldosteronic drugs improve lung diffusion and ventilatory efficiency during exercise; beta-blockers reduce exercise-induced hyperventilation. Furthermore, ultrafiltration improves lung mechanics, both at rest and during exercise, through body fluid content reduction. (c) 2006 Elsevier Ltd. All rights reserved.