Nitric oxide exhalation correlates with ventilatory response to exercise in patients with heart disease
Nitric oxide exhalation correlates with ventilatory response to exercise in patients with heart disease
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DOI：
10.1016/s1388-9842(03)00107-7
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发表时间：
2003-10-01
影响因子：
18.2
通讯作者：
Ito, H
中科院分区：
文献类型：
--
作者：
Adachi, H;Oshima, S;Ito, H
目的：心力衰竭患者的肺一氧化氮（NO）生成（反映在呼气末肺泡 NO 浓度中）是否减少存在争议。由于肺灌注受 NO 产生的调节，因此肺血管系统中 NO 产生的减少被认为会导致肺灌注减少并进一步增加通气-灌注失配。本研究的目的是调查呼出的一氧化氮是否与心脏病患者运动引起的呼吸过度和运动耐量相关。方法和结果：42 名心脏病患者入组（既往有心肌梗死病史（n = 19）、扩张型心肌病病史（n = 2）、高血压性心脏病病史（n = 5）和既往心脏直视手术史（n = 16））。在心肺运动测试期间，收集呼出的空气并使用化学发光方法测量呼气末一氧化氮（ETNO）。研究发现，ETNO 峰值与通气无氧阈值 (r = 0.468) 和 Vo(2) 峰值 (r = 0.562) 呈正相关。 VE-CO2 斜率反映运动对通气的反应，与 ETNO 峰值呈负相关 (r = -0.588)。结论：这些数据表明，NO 呼出量与运动的通气反应呈负相关，与运动不耐受呈正相关，尽管相关系数较弱表明可能存在其他可能的机制。 (C) 2003 年欧洲心脏病学会。由 Elsevier B.V. 出版。保留所有权利。
Aims: It is controversial whether or not pulmonary nitric oxide (NO) production, reflected in the end-tidal alveolar NO concentration, is diminished in patients with heart failure. Since pulmonary perfusion is regulated by NO production, decreased NO production in the pulmonary vasculature is assumed to result in diminished lung perfusion and further increases in ventilation-perfusion mismatch. The aim of this study is to investigate whether exhaled NO correlates with both exercise-induced hyperpnea and exercise tolerance in patients with heart disease. Methods and Results: Forty-two patients with heart disease were enrolled (history of prior myocardial infarction (n = 19), dilated cardiomyopathy (n = 2), hypertensive heart disease (n = 5) and prior open-heart surgery (n = 16)). During cardiopulmonary exercise testing, exhaled air was collected and end-tidal NO (ETNO) was measured using a chemiluminescent method. Peak ETNO was found to correlate positively with both ventilatory anaerobic threshold (r = 0.468) and peak Vo(2) (r = 0.562). The VE-CO2 slope, which reflects the ventilatory response to exercise, correlated negatively with peak ETNO (r = -0.588). Conclusion: These data indicate that NO exhalation correlates, inversely, with the ventilatory response to exercise and directly with exercise intolerance, although the weakness of the correlation coefficient suggests there may be other possible mechanisms. (C) 2003 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.