Genese der Atemeffizienzstörung unter Belastung bei Patienen mit chronischer Herzinsuffizienz: Rolle der pulmonalen Perfusion und einer veränderten kardiorespiratorischen Reflexaktivierung

慢性心力衰竭患者压力下呼吸效率受损的成因：肺灌注和心肺反射激活改变的作用

• 批准号: 5456812
• 负责人: Dr. Roland Wensel
• 金额: --
• 依托单位: Watford General Hospital
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2006
• 资助国家: 德国
• 起止时间: 2005-12-31 至 2008-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/5456812?language=en
• 关键词: Genese; der; Atemeffizienzst; rung; unter

Reduced ventilatory efficiency (as measured as the slope of the linear regression line relating ventilation to carbon dioxide output [VE/VCO2-slope]) is a key feature of chronic heart failure. It is closely associated with patients¿ symptom state and eclipses even peak oxygen consumption in the prognostic assessment of these patients. Alveolar dead space ventilation, which results from an uneven pulmonary blood flow distribution, is the major contributor to the increased VE/VCO2-slope in heart failure. It is unclear whether it reflects a primary pulmonary vascular pathology or simply the failure to adequately increase cardiac output during exercise. Hyperventilation another contributor to an increased VE/VCO2-slope is thought to arise from abnormal ventilatory stimuli, namely muscle-ergoreflex activation, during exercise. Its relation to cardiac output has not been investigated so far. We, therefore, aim to investigate the effects of acute and chronic changes in cardiac output on alveolar dead space ventilation, ergoreflex activation and exercise induced hyperventilation in patients with chronic heart failure.

通气效率降低（以通气量与二氧化碳输出[VE/VCO2-slope]相关的线性回归线斜率来测量）是慢性心力衰竭的一个关键特征。它与患者的症状状态密切相关，在这些患者的预后评估中甚至超过峰值耗氧量。肺泡死腔通气是肺脏血流分布不均匀造成的，是心力衰竭患者VE/ vco2斜率升高的主要原因。目前尚不清楚这是否反映了原发性肺血管病变或仅仅是在运动时未能充分增加心输出量。过度通气另一个导致VE/ vco2斜率增加的因素被认为是由异常通气刺激引起的，即运动过程中肌肉ergoreflex的激活。其与心输出量的关系迄今尚未研究。因此，我们的目的是研究急性和慢性心排血量变化对慢性心力衰竭患者肺泡死腔通气、ergoreflex激活和运动诱导的过度通气的影响。