Alteration of peripheral vasodilatory reserve capacity after cardioversion of atrial fibrillation.
Alteration of peripheral vasodilatory reserve capacity after cardioversion of atrial fibrillation.
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房颤复律后外周血管舒张储备能力的变化。
DOI：
10.1093/oxfordjournals.eurheartj.a014975
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发表时间：
1996
影响因子：
39.3
通讯作者：
K. Lie
中科院分区：
文献类型：
--
作者：
A. T. Gosselink;A. Smit;H. Crijns;H. Hillege;K. Lie
在房颤患者中，运动能力通常会降低。这通常归因于与窦性心律相比心输出量减少。然而，很少有研究将房颤时外周血流量的变化作为运动受限的潜在机制。本研究的目的是确定房颤转为窦性心律对周围血流量的影响。对28例符合电复律条件的慢性房颤患者，用心电触发的静脉阻断体积描记仪测定小腿血流量，用平板运动试验测定峰值氧耗量(VO2)。分别于复律前、复律后1天和1个月进行测量。测定小腿运动后即刻充血反应时的静息小腿血流量、最大小腿血流量和最小小腿血管阻力。复律后1天和1个月分别有23例和14例患者仍为窦性心律。1个月后仍有窦性心律的患者，小腿最大血流量由33.7±/-12增至40.0+/-13毫升·100ml~(-1)·分~(-1)(P<；0.01)，小腿最小血管阻力由3.2±-0.9降至2.7±0.7毫米汞柱。Ml-1。100ml-1。Min-1(P<0.01)，VO2峰值由21.3+/-4增至24.2+/-5ml.min-1。Kg-1(P<；0.001)。静息状态下小腿血流量未见改善。反之，房颤患者转复后1个月最大小腿血流量、最小小腿血管阻力和最大血氧饱和度均无明显变化。转复后1个月小腿最大血流量变化与血氧分压峰值呈显著正相关(r=0.53，P<0.01)。复律后第1天，无论是窦性心律患者还是房颤患者，小腿血流量和血氧饱和度峰值均未见改变。总而言之，从慢性房颤到窦性心律的转变与小腿最大血流量、小腿最小血管阻力和最大VO2的(延迟)改善有关。结果提示，心房颤动复律后血管储备能力的增加可能有助于运动能力的提高。
In atrial fibrillation, exercise capacity is often reduced. This is usually ascribed to a decreased cardiac output as compared with sinus rhythm. Very few studies, however, have focused on changes in the peripheral blood flow during atrial fibrillation as a potential mechanism for exercise limitation. The aim of the present study was to determine the effect of conversion of atrial fibrillation to sinus rhythm on peripheral blood flow. Calf blood flow, using an electrocardiogram-triggered venous occlusion plethysmograph, and peak oxygen consumption (peak VO2), using treadmill exercise testing, were studied in 28 patients with chronic atrial fibrillation eligible for electrical cardioversion. Measurements were performed before cardioversion, and repeated 1 day and 1 month thereafter. Calf blood flow at rest, maximal calf blood flow, and minimal calf vascular resistance during the hyperaemic response immediately following 700 J of calf exercise were determined plethysmographically. One day and 1 month after cardioversion, 23 and 14 patients were still in sinus rhythm, respectively. In patients who still had sinus rhythm after 1 month, maximal calf blood flow increased from 33.7 +/- 12 to 40.0 +/- 13 ml. 100 ml-1.min-1 (P < 0.01) and minimal calf vascular resistance fell from 3.2 +/- 0.9 to 2.7 +/- 0.7 mmHg. ml-1. 100 ml-1. min-1 (P < 0.01); peak VO2 increased from 21.3 +/- 4 to 24.2 +/- 5 ml. min-1. kg-1 (P < 0.001). Calf blood flow at rest did not improve. In contrast, no significant changes in maximal calf blood flow, minimal calf vascular resistance and peak VO2 occurred in patients who had atrial fibrillation 1 month after cardioversion. A significant correlation was found between changes in maximal calf blood flow and peak VO2 1 month after cardioversion (r = 0.53, P < 0.01). One day after cardioversion, no changes in calf blood flow or peak VO2 were found, either in patients with sinus rhythm or atrial fibrillation. In conclusion, transition from chronic atrial fibrillation to sinus rhythm is associated with a (delayed) improvement in maximal calf blood flow, minimal calf vascular resistance, and peak VO2. Our findings suggest that increase in vasodilatory reserve capacity may contribute to the improvement of exercise capacity after cardioversion of atrial fibrillation.
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DOI：
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发表时间：
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