Hemodynamic changes after meals and placebo treatment in chronic congestive heart failure.
Hemodynamic changes after meals and placebo treatment in chronic congestive heart failure.
复制标题
慢性充血性心力衰竭的餐后和安慰剂治疗后的血流动力学变化。
DOI：
10.1016/0002-9149(86)90898-2
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发表时间：
1986
期刊：
影响因子：
--
通讯作者：
Leier,CV
中科院分区：
文献类型：
--
作者：
Cornyn,JW;Massie,BM;Unverferth,DV;Leier,CV
为了确定在没有治疗干预的情况下是否会发生显著的自发性血流动力学变化，15例稳定性心力衰竭患者接受了右侧心导管插入术，并在8小时内进行了观察，没有积极治疗。心率（最小82 ± 19次/分，最大88 ± 18次/分，p <0.05）和心脏指数（最小2.14 ± 0.45升/分/m2，最大2.42 ± 0.79升/分/m2，p <0.05）增加。观察到肺动脉楔压（最大值24 ± 7 mm Hg，最小值21 ± 7 mm Hg，p <0.05）和全身血管阻力（最大值1，600 ± 280 dynes-s-cm-5，最小值1，390 ± 310 dynes-cm-5，p <0.05）降低。除肺动脉楔压降低外，所有血流动力学变化似乎与进食有关。此外，观察到平均血压在餐后统计学上显著降低（餐前85 ± 12 mm Hg，餐后78 ± 11 mm Hg，p <0.05）。这些数据强调了在解释微小的血流动力学变化时需要谨慎，即使具有统计学意义，并且它们表明在药物研究中纳入安慰剂组或阶段以及在吸收后状态下进行血流动力学测量的可取性。
To determine whether significant spontaneous hemodynamic changes occur without therapeutic intervention, 15 patients with stable heart failure underwent right-sided cardiac catheterization and were observed without active treatment during an 8-hour period. Significant changes that mimic those seen during treatment with vasodilating medications were found. Increases were seen in heart rate (minimum 82 ± 19 beats/min, maximum 88 ± 18 beats/min, p <0.05) and cardiac index (minimum 2.14 ± 0.45 liters/min/m2, maximum 2.42 ± 0.79 liters/min/m2, p <0.05). Decreases were observed in pulmonary artery wedge pressure (maximum 24 ± 7 mm Hg, minimum 21 ± 7 mm Hg, p <0.05) and systemic vascular resistance (maximum 1,600 ± 280 dynes-s-cm5, minimum 1,390 ± 310 dyness-cm−5, p <0.05). Except for the decrease in pulmonary artery wedge pressure, all hemodynamic changes appeared to be related to eating. In addition, a statistically significant postprandial decrease in mean blood pressure (before meal 85 ± 12 mm Hg, after meal 78 ± 11 mm Hg, p <0.05) was seen. These data reinforce the need for caution in interpreting small hemodynamic changes, even if statistically significant, and they indicate the desirability of Including placebo groups or phases in drug studies and of performing hemodynamic measurements in the postabsorptive state.