Effects of hypertension and obesity on the sympathetic activation of heart failure patients
Effects of hypertension and obesity on the sympathetic activation of heart failure patients
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DOI：
10.1161/01.hyp.0000098660.26184.63
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发表时间：
2003-11-01
期刊：
影响因子：
8.3
通讯作者：
Mancia, G
中科院分区：
文献类型：
--
作者：
Grassi, G;Seravalle, G;Mancia, G
以往的研究表明，充血性心力衰竭的特点是交感神经和反射功能障碍。这些改变是否在肥胖和高血压的存在下增强，这两种情况也显示神经肾上腺素能异常并显着增加心力衰竭的风险，目前尚不清楚。在14名健康对照者中（C;年龄，55.1 ± 3.0岁;平均值+/-SEM），13名瘦型高血压受试者（H），15名肥胖型血压正常受试者（O），14名瘦型血压正常受试者伴充血性心力衰竭（CHF，纽约心脏协会II级），14名患有CHF的瘦型高血压受试者（CHFH），14名患有CHF的肥胖型血压正常受试者（CHFO），和13名肥胖高血压伴CHF（CHFOH）受试者，所有年龄均与C相匹配，我们测量了静息和压力反射试验期间的平均血压（Finapres）、心率（ECG）和肌肉交感神经交通（MSNA，显微神经造影）。与C组相比，O、CHFO和CHFOH组的体重指数增加相似，而HF、CHFH和CHFOH组的平均血压增加相似，CHF、CHFH、CHFO和CHFOH组的左心室射血分数（超声心动图）降低相似。与C组相比，O、H和CHF组MSNA显著升高（43.0+/-2.2 vs 54.1+/-2.8，53.1 +/-2.5和57.4+/-2.8爆发/100次心跳，P
Previous studies have shown that congestive heart failure is characterized by sympathetic and reflex dysfunctions. Whether these alterations are potentiated in the presence of obesity and hypertension, two conditions that also display neuroadrenergic abnormalities and markedly increase the risk of heart failure, is unknown. In 14 healthy control subjects (C; age, 55.1+/-3.0 years; mean+/-SEM), 13 lean hypertensive subjects (H), 15 obese normotensive subjects (O), 14 lean normotensive subjects with congestive heart failure (CHF, New York Heart Association class II), 14 lean hypertensive subjects with CHF (CHFH), 14 obese normotensive subjects with CHF (CHFO), and 13 obese hypertensive subjects with CHF (CHFOH), all age-matched with C, we measured mean blood pressure (Finapres), heart rate (ECG), and muscle sympathetic nerve traffic (MSNA, microneurography) at rest and during baroreflex testing. Compared with C, body mass index was similarly increased in O, CHFO, and CHFOH, whereas mean blood pressure was similarly increased in HF, CHFH, and CHFOH, and left ventricular ejection fraction (echocardiography) was similarly reduced in CHF, CHFH, CHFO and CHFOH. Compared with C, MSNA was significantly increased in O, H, and CHF (43.0+/-2.2 versus 54.1+/-2.8, 53.1+/-2.5, and 57.4+/-2.8 bursts/100 heart beats, P